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Introducción: La mastoplastia de reducción mediante la técnica de pedículo inferior es una de las intervenciones quirúrgicas estéticas más empleadas para corregir la hipertrofia mamaria. Objetivo: Caracterizar a las pacientes con hipertrofia mamaria, a quienes se les practicó mastoplastia de reducción con la técnica de pedículo inferior. Métodos: Se realizó un estudio descriptivo, observacional, transversal y retrospectivo de 185 pacientes entre 10 y 59 años de edad, con diagnóstico de hipertrofia mamaria, atendidas en el Servicio de Cirugía Plástica y Caumatología del Hospital General Docente Octavio de la Concepción y de la Pedraja del municipio de Baracoa, a las cuales se les practicó mastoplastia de reducción por técnica de pedículo inferior, desde enero de 2004 hasta diciembre 2020. Resultados: En la serie predominaron las féminas entre 30-39 años de edad (42,8 %), los resultados estéticos evaluados de buenos (90,3 %), las complicaciones escasas (20,0 %), con primacía de la necrosis de la piel en el punto inferior de unión de los colgajos (7,0 %) y las pacientes satisfechas con el proceder (93,5 %). El tejido glandular resecado varió entre menos de 300 g y más de 1 200, según el grado de hipertrofia. Conclusiones: La técnica de reducción mamaria a pedículo inferior es versátil, segura y aplicable a todo tipo de hipertrofia, con una tasa de complicaciones baja; asimismo ofrece resultados estéticos favorables y alto grado de satisfacción.
Introduction: The reduction mastoplasty by means of the inferior pedicle technique is one of the most used cosmetic surgical interventions to correct mammary hypertrophy. Objective: To characterize the patients with mammary hypertrophy to whom reduction mastoplasty was practiced with the inferior pedicle technique. Methods: A descriptive, observational, cross-sectional and retrospective study of 185 patients between 10 and 59 years, with diagnosis of mammary hypertrophy was carried out. They were assisted in the Plastic Surgery and Caumatology Service of Octavio de la Concepción y de la Pedraja Teaching General Hospital from the municipality of Baracoa, to whom reduction mastoplasty by inferior pedicle technique was practiced, from January, 2004 to December, 2020. Results: In the series there was a prevalence of the females between 30-39 years (42.8 %), the cosmetic results with good evaluation (90.3 %), few complications (20.0 %), with primacy of the skin necrosis in the inferior space of the flap union (7.0 %) and the patients satisfied with the procedure (93.5 %). The dried up glandular tissue varied in less than 300 grams and more than 1 200, according to the degree of hypertrophy. Conclusions: The mammary reduction technique to inferior pedicle is versatile, safe and applicable to all types of hypertrophy, with a low rate of complications; also it offers favorable cosmetic results and high degree of satisfaction.
Subject(s)
Breast , Mammaplasty/methods , Plastic Surgery Procedures/methods , HypertrophyABSTRACT
Objective To introduce a modified vertical scar method (Hall-Findlay method) and its improved technique.Methods From May 2009 to May 2018,128 cases of female mammoplasty were completed in the Department of Plastic Surgery,Nanfang Hospital of Southern Medical University,aged 22 to 49 years,with an average of 38.3 years.56 cases underwent breast reduction surgery and 72 cases underwent breast suspension surgery.The surgical incision was designed according to the Hall Findlay method.Firstly,the inner skin of the design line was shaved to form a leather cap,the breast tissue was removed,the upper or inner pedicle was preserved,and the Würinger's horizontal septum structure was arranged to ensure the blood supply and innervation of the nipple areolar complex.The partially enlarged basal mammary gland tissue was removed,and the remaining mammary tissue was fixed upward at the second rib level.The redundant skin of the breast was fully reduced and sutured.For patients with obvious breast hypertrophy,intraoperative combined aspiration of fat was used,mainly to reduce the subcutaneous fat of the lateral and lateral chest of the breast gland.Results A total of 128 cases of breast disease and simple breast sagging were treated with this method.Only 1 case showed nipple areolar complex ischemia in the early postoperative period.After 3 months to 6 months follow-up,the breast shape was good and the satisfactory rate was over 95％.Conclusions This procedure is modified from the Lejour method of vertical scar mammoplasty.The full thickness of the pedicle is preserved compared with the Lejour method.The anatomical structure of the horizontal septum is preserved during the operation to reduce the postoperative nipple-areolar complex dysfunction and poor blood supply.The probability of occurrence and the long-term effect are good,the shape of the breast is straight,and it is worth promoting.
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Introducción: La patología mamaria en pacientes pediátricos que amerite tratamiento quirúrgico es poco frecuente, ya que la mayoría de las veces solo requiere observación y manejo médico. Objetivos: Determinar la experiencia de 10 años dentro de la clínica de mama del Hospital Infantil de México, en el manejo quirúrgico de la patología en mama de pacientes pediátricos. Diseño: Estudio retrospectivo, trasversal y descriptivo. Institución: Hospital Infantil de México Federico Gómez, México DF. Participantes: Pacientes de 2 a 18 años de edad. Métodos: Se realizó búsqueda en archivos médicos en el periodo 2001 a 2011, de alguna patología mamaria tratada quirúrgicamente. Principales medidas de resultados: Patología mamaria y tratamiento quirúrgico. Resultados: En 159 pacientes, se encontró que la patología más frecuente en el sexo femenino fue el fibroadenoma mamario, y en el sexo masculino la ginecomastia. Todos los fibroadenomas mamarios y adenomas tuvieron tratamiento quirúrgico a base de escisión total; las polimastias fueron sometidas a resección; las ginecomastias fueron tratadas mediante mastectomía subcutánea; se trató las mastopatías fibroquísticas mediante escisión simple o mastectomía subcutánea. La hipertrofia virginal mamaria fue sometida a mastectomía subcutánea y reducción mamaria; y en el fibroadenoma gigante, los pacientes tuvieron resección, mastectomía subcutánea o reducción mamaria. Conclusiones: Consideramos que la gran mayoría de patologías benignas, al presentar indicación, podrán ser resueltas de forma satisfactoria con el tratamiento quirúrgico adecuado. Aunque con poca incidencia, la patología mamaria maligna está presente en este grupo de edad.
Background: Breast pathology in children and adolescents is rare and usually benign. Most require only medical treatment and observation; however, some can have surgical indications. Objectives: To determine the 10-year experience at Hospital Infantil de Mexico's breast clinic in treatment of breast pathology in children. Design: Retrospective, trasversal and descriptive study. Setting: Hospital Infantil de Mexico Federico Gomez, Mexico DF. Participants: Patients 2 to 18 year-old. Methods: Search of med-excision, polimastia by resection, gynecomastia by subcutaneical files of breast pathology treated surgically in the period 2001-ous mastectomy, fibrocystic breast disease by simple excision 2011. Main outcome measures: Breast pathology and surgical or subcutaneous mastectomy, virginal mammary hypertrophy treatment. Results: In 159 patients the most frequent pathology by subcutaneous mastectomy or mammary reduction, and giant on females was fibroadenoma, and gynecomastia in males. Fi-fibroadenoma by simple excision, subcutaneous mastectomy or broadenomata and adenomata were treated by total surgical mammary reduction. Conclusions: We consider that most breast pathology in children is usually benign and can be treated satisfactorily by adequate surgery. Although with low incidence malignant breast disease is also possible in this age group.
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Objective To investigate the expression of the cyclin D1 in pubertal mammary hypertrophy and micromastia. Methods The expression of cyclin D1 was detected by SP immunohisto-chemistry in 18 cases of pubertal mammary hypertrophy and 12 cases of micromastia. Results The expression rate of cyclin D1 within breast tissue was 83. 33 % and 16. 67 % in pubertal mammary hypertrophy and micromastia, respectively. There was significant difference between the two groups (P<0. 01). Conclusion The expression level of the cyclin D1 within breast tissue in pubertal mammary hypertrophy is higher than that in micromastia.
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Objective To investigate the expression of the ER,CyclinD1 in breast tissue of pubertal mammary hypertrophy and explore the possible etiology of pubertal mammary hypertrophy.Methods The expression of ER,CyclinD1 was detected by Western-blot in 15 cases of pubertal mammary hypertrophy,15 normal breast tissue and 10 cases of micromastia.Results There was significant difference of the expression of ER,CyclinD1 within breast tissue between pubertal mammary hypertrophy and micromastia(P＜0.01).There was significant difference of the expression of ER,CyclinD1 within breast tissue in pubertal mammary hypertrophy and in normal breast tissue(P＜0.01).There was no difference between the expression of ER,CyclinD1 within breast tissue in micromastia and in normal breast tissue(P＞0.05).Conclusions The expression of ER,CyclinD1 in pubertal mammary hypertrophy are significantly higher than in micromastia and normal breast tissue.The pubertal mammary hypertrophy may be related to the expression status of ER,CyclinD1 within breast tissue.
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O tratamento cirúrgico de neoplasias mamárias benignas e malignas, assim como a abordagem de hipertrofias e assimetrias mamárias, requer do mastologista conhecimentos técnicos anteriormente utilizados apenas na área da cirurgia plástica. As técnicas de mamoplastia redutora utilizadas nos dias atuais derivam de técnicas descritas há muitos anos, com diferentes adaptações, objetivando sempre melhores resultados imediatos e tardios. As alterações estruturais e cicatriciais provocadas por esse tipo de cirurgia devem ser bem conhecidas e acompanhadas quando for empregada na solução de problemas oncológicos. Nesta breve revisão, discutem-se diversos aspectos técnicos e conceituais referentes à mamoplastia redutora com relevância na clínica mastológica atual.
New trends in breast cancer surgery motivated breast surgeons to get acquainted with surgical skills formerly only employed in aesthetic surgery. The modern surgical approach to reduction mammaplasty represents a surgical procedure improvement for better shape and reduced scars. Postsurgical changes, some of which may mimic cancer must be recognized and followed by mammography and clinical examination. In this review, we go through some issues about reduction mammaplasty and its importance for breast surgeons.