Mastopexy with Mammary Parenchymal Z-plasty Pattern

유방 실질 조직 Z-성형술을 이용한 유방 하수 교정술

  • Kim, Kyung-Pil (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Kim, Ji-Hoon (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Hwang, Jae-Ha (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Kim, Kwang-Seog (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Lee, Sam-Yong (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School)
  • 김경필 (전남대학교 의과대학 성형외과학교실) ;
  • 김지훈 (전남대학교 의과대학 성형외과학교실) ;
  • 황재하 (전남대학교 의과대학 성형외과학교실) ;
  • 김광석 (전남대학교 의과대학 성형외과학교실) ;
  • 이삼용 (전남대학교 의과대학 성형외과학교실)
  • Received : 2011.02.15
  • Accepted : 2011.06.13
  • Published : 2011.07.10

Abstract

Purpose: To correct breast ptosis, reduction mammoplasty and mastopexy have been developed in a way that minimizes complications. Recently, as the mean age of breast cancer occurrence is decreasing, the need for breast reconstruction in patients with breast cancer is rising. If mastopexy is performed with breast reconstruction at the same time, the size of the normal breast and the new one is not quite different. We decided to apply Z-plasty, which is a widely-used technique in plastic surgery to lengthen or change the direction of tension of the tissue. Methods: From March 2008 to December 2009, we performed breast reconstruction in 6 patients with breast cancer and scar contracture. After breast reconstruction, mastopexy with Z-plasty was applied to correct the asymmetry. The new nipple-areolar complex is placed on the line connecting the midclavicle and the current nipple. The inferior border of the new areola corresponds with the inferior border of the original areola, and the superior border about 2 cm upward the original superior border. We drew two oblique lines connecting the medial end of the incision line lower to the nipple-areola complex and the lateral end of the inframammary fold for Z-plasty. The excess tissue between these two lines was removed and the new triangular flaps were put together. Results: The average age of patients was 42.6 years, aged from 36.1 to 48.1 The weight of removed tissue was between 54g and 95 g, with the mean of 74 g. The average distance from the midclavicle to the nipple was 24 cm before surgery, and 21 cm after the surgery. The average operation time per patient (1 mastopexy) was 45 minutes, and the patients were satisfied with the size and shape. Conclusion: Applying Z-plasty for the mastopexy on the normal breast ptosis is a relatively simple way to achieve symmetry in patients who need breast reconstruction.

Keywords

References

  1. Pitanguy I: Surgical treatment of breast hypertrophy. Br J Plast Surg 20: 78, 1967 https://doi.org/10.1016/S0007-1226(67)80009-2
  2. Losken A, Hotz DJ: Versatility of the superomedial pedicle in managing the massive weight loss breast: the rotation-advancement technique. Plast Reconstr Surg 120: 1060, 2007 https://doi.org/10.1097/01.prs.0000278004.24650.e6
  3. McKissock PK: Reduction mammaplaty with a vertical dermal flap. Plast Reconstr Surg 49: 245, 1972 https://doi.org/10.1097/00006534-197203000-00001
  4. Courtiss EH, Goldwyn RM: Reduction mammaplasty by the inferior pedicle technique. an alternative to free nipple and areola grafting for severe macromastia or extreme ptosis. Plast Reconstr Surg 59: 500, 1977 https://doi.org/10.1097/00006534-197759040-00004
  5. Georgiade NG, Georgiade GS, Riefkohl R: Esthetic breast surgery. In McCathy JG (eds): Plastic surgery. 1st ed, Philadelphia. WB Saunders Co, 1990, p 3847
  6. Loustau HD, Mayer HF, Sarrabayrouse M: The Owl technique combined with the inferior pedicle in mastopexy. Aesthetic Plastic Surg 32: 11, 2008 https://doi.org/10.1007/s00266-007-9032-7
  7. Felicio Y: Periareolar reduction mammaplasty. Plast Reconstr Surg 88: 789, 1991 https://doi.org/10.1097/00006534-199111000-00007
  8. Lejour M: Vertical mammaplasty and liposuction of the breast. Plast Reconstr Surg 94: 100, 1994 https://doi.org/10.1097/00006534-199407000-00010
  9. Vrebos J, Dupuis C: [From a single vertical scar to vertical mammaplasty. From Louis Dartigues (1869-1940) to Claude Lassus (1933)]. Ann Chir Plast Esthet 45: 62, 2000
  10. Khan UD: Vertical scar with the bipedicle technique: a modified procedure for breast reduction and mastopexy. Aesthetic Plast Surg 31: 337, 2007 https://doi.org/10.1007/s00266-006-0243-0
  11. Chiari Junior A: The L short-scar mammoplasty: a new approach. Plast Reconstr Surg 90: 233, 1992 https://doi.org/10.1097/00006534-199290020-00011
  12. Reno WT: Reduction mammoplasty with circular folded pedicle technique. Plast Reconstr Surg 90 : 65, 1992 https://doi.org/10.1097/00006534-199207000-00010
  13. Benelli L: A new periareolar mammaplasty: the "round block" technique. Aesthetic Plast Surg 14: 93, 1990 https://doi.org/10.1007/BF01578332
  14. de Benito J, Sanza IF: Periareolar techniques for mammary reduction and elevation. Aesthetic Plast Surg 17: 311, 1993 https://doi.org/10.1007/BF00437104