유방재건시 유방하 주름의 생성

Inframammary Fold Creation in Breast Reconstruction

  • 이혜민 (한양대학교 의과대학 성형외과학교실) ;
  • 안희창 (한양대학교 의과대학 성형외과학교실) ;
  • 최승석 (한양대학교 의과대학 성형외과학교실) ;
  • 조동인 (한양대학교 의과대학 성형외과학교실) ;
  • 변태호 (한양대학교 의과대학 성형외과학교실)
  • Lee, Hae Min (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Ahn, Hee Chang (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Choi, Seung Suk (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Jo, Dong In (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Byun, Tae Ho (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University)
  • 투고 : 2004.09.30
  • 발행 : 2005.03.10

초록

Nowadays breast reconstruction with autologous tissues after radical mastectomy is commonly performed, and a natural inframammary fold in the reconstructed breast is considered to be an essential aspect of symmetrical breast shape and location. Total of 104 patients underwent breast reconstruction with free TRAM flap and formation of inframammary fold with free TRAM breast reconstruction was done in 79 patients. No suture fixation for inframammary fold were done in 19 patients. 27 patients(24.0%) were made of inframammary fold with absorbable suture, 52 patients (50.0%) underwent inframammary fold creation with nonabsorbable suture. There were 4 cases(16.0%) of displacement of reconstructed breast and 2 cases(8.0%) of partial disruption of inframammary fold in the group of no suture. There were 2 cases(7.4%) of displacement of reconstructed breast and 3 cases(11.1%) of partial disruption of inframmamary fold in the fixed group with absorbable suture. There was only 1 case(1.9%) of partial disruption of inframammary fold fixed with nonabsorbable suture group. Therefore, we could speculate that the reinforcement of ligamentous structure for making the definite inframammary fold is necessary, and the area of the inframammary fold should not be undermined in immediate breast reconstruction as much as possible in order to preserve the zone of adherence. If the fold is disrupted during the mastectomy, it should be re-created with the non-absorbable sutures. Nonabsorbable suture fixation seemed to be more stable than absorbable suture. Preoperative marking and design are very important to make the symmetrical shape and location of inframammary fold in both of immediate and delayed reconstruction of breasts.

키워드

참고문헌

  1. Nava M, Quattrone P, Riggio E: Focus on the breast fascial system: a new approach for Inframammary fold reconstruction. Plast Reconstr Surg 102: 1034, 1998 https://doi.org/10.1097/00006534-199809040-00018
  2. Maillard GF, Garey LJ: An improved technique for Creation of the Inframammary Fold in Silicon Implant Breas Reconstruction. Plast Reconstr Surg 89: 558, 1991 https://doi.org/10.1097/00006534-199203000-00030
  3. Pennisi VR: Making a definite Inframammary fold under a reconstructed breast. Plast Reconstr Surg 60: 523, 1977 https://doi.org/10.1097/00006534-197710000-00004
  4. Muntan CD, Sundine MJ, Rink RD, Acland RD: Inframammary fold: a histologic reappraisal. Plast Reconstr Surg 105: 549, 2000 https://doi.org/10.1097/00006534-200002000-00011
  5. Van Straalen WR, Hage JJ, Bloemena E: The Inframammary ligament: myth or reality? Ann Plast Surg 35: 237, 1995 https://doi.org/10.1097/00000637-199509000-00003
  6. Lockwood TE: Superficial fascial system(SFS) of the trunk and extremities: A new concept. Plast Reconstr Surg 87: 1009, 1991 https://doi.org/10.1097/00006534-199106000-00001
  7. Bayati S, Seckel BR: Infrarnammary crease ligament. Plast Reconstr Surg 95: 501, 1995 https://doi.org/10.1097/00006534-199503000-00010
  8. Dowden RV: Achieving a natural Inframammary fold and ptotic effect in the reconstructed breast. Ann Plast Surg 19: 524, 1987 https://doi.org/10.1097/00000637-198712000-00009