Journal of Plastic Reconstructive and Aesthetic Surgery最新文献_第9页

Retrospective cohort study on pedicled flap reconstruction after trunk soft tissue sarcoma resection: Surgical outcomes and survival analysis 躯干软组织肉瘤切除术后带蒂皮瓣重建的回顾性队列研究：手术效果及生存分析

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-12 DOI: 10.1016/j.bjps.2025.11.012

Fu Laihua , Xiao Wanyi , Liu Yuanxin , Huang Jingyang , Zhou Yang , Xu Songfeng , Qiu Jin , Zhao Zhigang , Yang Jilong

Background and objective

Although pedicled flaps are widely used in trunk reconstruction, evidence remains limited regarding their efficacy in patients with soft tissue sarcoma (STS) requiring wide resection with skeletal involvement.

Methods

This retrospective cohort study analyzed 42 consecutive patients who underwent pedicled flap reconstruction after trunk sarcoma resection at our institution (2019–2024). Flap types included 30 fasciocutaneous and 12 myocutaneous flaps. Outcomes included flap survival (photographic/Doppler assessment) and complications (Clavien-Dindo). Statistical analysis was performed using the Fisher's exact test and Kaplan-Meier methods (SPSS v26).

Results

The cohort demonstrated favorable outcomes with pedicled flap reconstruction (92.86% primary healing rate). Among skeletal defect cases, reconstructions used soft prostheses (n = 6), rigid prostheses (n = 2), or mesh reinforcement (n = 2). During the 11–59 month follow-up period, distant metastases developed in 14.29% of cases (3 pulmonary, 2 hepatic, and 1 peritoneal) (5 pulmonary, 2 pulmonary and hepatic, and 1 peritoneal).

Conclusion

Our findings suggest that pedicled flap reconstruction following wide resection of trunk soft tissue sarcomas is associated with satisfactory outcomes (92.9% primary healing rate) and low major complication rates (7.1% Grade I–II complications). These results indicate that pedicled tissue flaps represent a viable reconstructive option when tumor clearance can be achieved.

背景与目的尽管带蒂皮瓣被广泛应用于躯干重建，但其在需要广泛切除并累及骨骼的软组织肉瘤（STS）患者中的疗效证据仍然有限。方法回顾性队列研究分析了我院（2019-2024）连续42例躯干肉瘤切除术后行带蒂皮瓣重建的患者。皮瓣类型包括30个筋膜皮瓣和12个肌皮瓣。结果包括皮瓣存活（摄影/多普勒评估）和并发症（Clavien-Dindo）。采用Fisher精确检验和Kaplan-Meier方法（SPSS v26）进行统计分析。结果带蒂皮瓣重建效果良好，一期愈合率为92.86%。在骨骼缺损病例中，重建采用软性假体（n = 6）、刚性假体（n = 2）或网状补强（n = 2）。在11-59个月的随访期间，14.29%的病例发生远处转移（3例肺，2例肝，1例腹膜）（5例肺，2例肺和肝，1例腹膜）。结论躯干软组织肉瘤大范围切除后带蒂皮瓣重建效果满意（一期愈合率92.9%），主要并发症发生率低（I-II级并发症7.1%）。这些结果表明，当肿瘤清除可以实现时，带蒂组织皮瓣是一种可行的重建选择。

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引用次数: 0

The thenar eminence as a reference standard for muscle flap turgor assessment in free tissue transfer for facial reanimation: A novel clinical assessment framework 鱼际隆起作为面部再生游离组织移植中肌肉瓣肿胀评估的参考标准：一种新的临床评估框架

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-12 DOI: 10.1016/j.bjps.2025.10.043

Jing Qin Tay, Sheng-Lian Lee, Alfonso Orlando, David Chwei-Chin Chuang

引用次数: 0

Novel technique for lacrimal duct reconstruction using a tubularized nasomucoperiosteal flap 应用管状鼻粘膜膜瓣重建泪道的新技术

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-12 DOI: 10.1016/j.bjps.2025.11.017

Ko Nakao , Masafumi Yamaga , Natsuki Kemuriyama , Eri Matoba , Hisashi Sakuma

The medial canthal region is a common site for skin cancers, and its resection often requires a concomitant lacrimal canaliculi resection. Although conventional reconstruction methods, such as dacryocystorhinostomy with placement of a Jones tube, autologous vascular grafting, and conjunctival flaps, have been used, each has notable drawbacks, including restenosis and conjunctivitis. Herein, we report a case of basal cell carcinoma of the lower eyelid in which the lower canaliculus was resected, followed by lacrimal duct reconstruction using a tubularized nasomucoperiosteal flap. A bony window was created from the tumor resection site to the nasal bone. Subsequently, a pedicled nasomucoperiosteal flap was elevated, tubularized, and anastomosed to the lower eyelid conjunctiva, allowing direct drainage of tears into the nasal cavity. At 6 months postoperatively, no complications, such as epiphora or conjunctivitis, were observed. Dacryocystography confirmed satisfactory tear drainage from the conjunctiva into the nasal cavity. This technique enables the reconstruction of a stenosis-resistant lacrimal duct using a pedicled nasomucoperiosteal flap that possesses favorable vascularity, flexibility, and adequate thickness and strength.

Lay summary

This report describes a novel technique for lacrimal duct reconstruction using a tubularized nasomucoperiosteal flap after canalicular resection for basal cell carcinoma. This method creates a durable tear drainage pathway, reducing restenosis and postoperative complications.

内眦区域是皮肤癌的常见部位，其切除通常需要同时切除泪小管。虽然传统的重建方法，如放置琼斯管的泪囊鼻腔造口术、自体血管移植和结膜瓣，已经被使用，但每种方法都有明显的缺点，包括再狭窄和结膜炎。在此，我们报告一个下眼睑基底细胞癌的病例，其中下小管被切除，然后用管状鼻黏膜瓣重建泪管。从肿瘤切除部位到鼻骨建立骨窗。随后，将带蒂鼻黏膜骨膜瓣抬高，管状化，与下睑结膜吻合，使泪液直接引流至鼻腔。术后6个月，无睑裂、结膜炎等并发症发生。泪囊造影证实泪液从结膜流入鼻腔。该技术可以使用带蒂的鼻黏膜骨膜瓣重建抗狭窄的泪管，该皮瓣具有良好的血管性、柔韧性和足够的厚度和强度。本报告描述了一种用于基底细胞癌小管切除后用管状鼻黏膜瓣重建泪管的新技术。这种方法创造了持久的泪液引流通道，减少了再狭窄和术后并发症。

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引用次数: 0

Chondrocutaneous composite grafts are a viable option for nasal alar defects larger than 1.5 cm 对于大于1.5 cm的鼻翼缺损，软骨-皮肤复合移植是一种可行的选择

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-12 DOI: 10.1016/j.bjps.2025.11.009

Daehee Jeong , William Y. Zhu , Braedon Quinlan , Mckenzie Maloney , Carl F. Schanbacher

Introduction

Nasal reconstructions are one of the most commonly performed plastic surgery procedures. The complex anatomy and critical functionality of the nose demand precise surgical approaches and planning. This is especially pertinent for subunits such as the ala. Chondrocutaneous composite grafts from the ear are excellent options for alar reconstruction, but are limited to a maximum diameter of 1.5 cm, according to historic guidelines. This study compared complication rates associated with composite grafts that are greater and smaller than the reported size limit.

Methods

A retrospective review was conducted for 53 patients who received auricular composite grafts for alar repair following Mohs micrographic surgery. Complications, including graft loss, infection, postoperative bleeding, hematoma, and functional deficits, were noted. Additionally, patients who received esthetic revisions were observed.

Results

Thirty-two grafts were <1.5 cm in diameter, and 21 were >1.5 cm in diameter. One patient had a postoperative complication, and 7 received esthetic revisional procedures. There were no significant size-dependent differences in complication rates (p = 0.396). There was a significant difference in esthetic revision rates between grafts greater than and smaller than 1.5 cm in diameter.

Conclusion

We present the first study examining the validity of using 1.5 cm as the upper diameter bound for composite grafts. Our results indicate that composite grafts are safe and effective for reconstruction of nasal ala defects >1.5 cm. These larger grafts may benefit from minor esthetic adjustments once they have healed.

鼻重建术是最常见的整形手术之一。鼻子复杂的解剖结构和关键的功能需要精确的手术方法和计划。这对于像ala这样的亚单位尤其重要。耳部软骨皮肤复合移植物是鼻翼重建的绝佳选择，但根据历史指南，其最大直径限制在1.5厘米。本研究比较了大于和小于报道尺寸限制的复合移植物的并发症发生率。方法回顾性分析53例莫氏显微摄影术后耳廓复合移植修复鼻翼的临床资料。并发症包括移植物丢失、感染、术后出血、血肿和功能缺陷。此外，还观察了接受美学修复的患者。结果移植物直径1.5 cm 32个，直径1.5 cm 21个。1例患者出现术后并发症，7例患者接受了美学修复手术。并发症发生率无明显尺寸依赖性差异（p = 0.396）。直径大于和小于1.5 cm的移植物在美观修复率上有显著差异。结论本研究首次验证了以1.5 cm为上径界作为复合移植物的有效性。结果表明，复合植体修复1.5 cm鼻翼缺损是安全有效的。这些较大的移植物在愈合后可以进行轻微的美学调整。

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引用次数: 0

Correspondence on: “Breast implant explantation with mastopexy in patients using GLP-1 receptor agonists: A retrospective comparative analysis” 对应于：“GLP-1受体激动剂对乳房植入与乳房固定术患者的回顾性比较分析”

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-12 DOI: 10.1016/j.bjps.2025.11.014

Federica Tomaselli, Roberta Albanese, Damiano Tambasco

引用次数: 0

A novel combined approach of stromal vascular fraction gel grafting and liposuction for postmastectomy upper extremity lymphedema: A prospective study 基质血管凝胶移植术与吸脂术联合治疗乳房切除术后上肢淋巴水肿的新方法：一项前瞻性研究

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-08 DOI: 10.1016/j.bjps.2025.11.006

Shune Xiao , Miaomiao Wei , Junzhe Chen , Xiangkui Wu , Hai Li , Bihua Wu , Chengliang Deng

Purpose

Conventional therapies for postmastectomy upper extremity lymphedema often provide limited and temporary relief, especially in advanced cases. Although surgical interventions such as liposuction have improved outcomes, combining regenerative cell-based strategies with surgical volume reduction has not been systematically evaluated. This prospective study assessed the feasibility, safety, and efficacy of combining stromal vascular fraction (SVF)-gel grafting with liposuction, targeting physical debulking and lymphatic regeneration in breast cancer-related upper extremity lymphedema.

Methods

In this prospective, single-arm exploratory study, 12 patients with stage II or III breast cancer-related upper extremity lymphedema underwent liposuction followed by SVF-gel transplantation. The primary endpoint was change in excess arm volume at 12 months. Secondary outcomes included symptom severity, quality of life (QoL; Disabilities of the Arm, Shoulder and Hand [DASH] and Lymphedema Quality-of-Life Questionnaire [LYMQOL] questionnaires), incidence of cellulitis, and reliance on compression therapy. Safety was monitored throughout. Statistical analyses included repeated measures analysis of variance (ANOVA) with Bonferroni corrections, Wilcoxon, and multi-linear regression to compare changes from baseline and identify factors influencing arm volume.

Results

At 12 months, the combined intervention achieved a mean 51% reduction in excess arm volume (from 668.3 ± 275.1 to 327.5 ± 164.1 mL, P < 0.05). Significant improvements were observed in limb heaviness, tension, upper extremity function, and LYMQOL subscales (all P < 0.01). Three patients discontinued compression therapy. No cellulitis or serious adverse events occurred; minor complications resolved without intervention.

Conclusion

Combining liposuction with SVF-gel grafting is a feasible, safe, and effective approach for advanced postmastectomy upper limb lymphedema and for improving symptoms and QoL. Given the lack of published data on this combined technique, our findings lay the foundation for future controlled studies.

目的：乳房切除术后上肢淋巴水肿的常规治疗通常提供有限和暂时的缓解，特别是在晚期病例中。尽管抽脂等手术干预措施改善了结果，但将再生细胞为基础的策略与手术体积缩小相结合尚未得到系统评估。这项前瞻性研究评估了基质血管分数（SVF）凝胶移植联合吸脂治疗乳腺癌相关上肢淋巴水肿的可行性、安全性和有效性，目标是物理减容和淋巴再生。方法在这项前瞻性单臂探索性研究中，12例II期或III期乳腺癌相关上肢淋巴水肿患者行吸脂术后svf凝胶移植。主要终点是12个月时多余臂体积的变化。次要结局包括症状严重程度、生活质量（QoL；手臂、肩和手的残疾[DASH]和淋巴水肿生活质量问卷[lyqol]问卷）、蜂窝织炎的发生率和对压迫治疗的依赖。安全受到全程监控。统计分析包括使用Bonferroni校正、Wilcoxon和多元线性回归的重复测量方差分析（ANOVA），以比较基线的变化并确定影响臂体积的因素。结果12个月后，联合干预使手臂多余体积平均减少51%（从668.3±275.1 mL降至327.5±164.1 mL, P < 0.05）。在肢体重、张力、上肢功能和lyqol亚量表上观察到显著改善（P均为0.01）。3例患者停止压迫治疗。未发生蜂窝织炎或严重不良事件；轻微并发症无需干预即可解决。结论吸脂联合svf凝胶移植治疗晚期乳房切除术后上肢淋巴水肿是一种可行、安全、有效的方法，可改善患者症状和生活质量。鉴于缺乏关于这种联合技术的公开数据，我们的发现为未来的对照研究奠定了基础。

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引用次数: 0

Time well spent? The impact of operative time on breast reduction outcomes 时间花得好吗？手术时间对缩乳效果的影响

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-07 DOI: 10.1016/j.bjps.2025.11.007

Samuel Knoedler , Florian Falkner , Marina T. Dietrich , Sarah Friedrich , Stefan O.P. Hofer , Giuseppe Sofo , Thomas Schaschinger , Gabriel Hundeshagen , Christoph Heitmann , Stefano Pompei , Dennis P. Orgill , Adriana C. Panayi , Bong-Sung Kim

Background

Although extended operative duration increases risks in other surgeries, its impact on breast reduction outcomes remains unclear. This retrospective cohort study investigated the relationship between operative time and postoperative morbidity in breast reduction.

Methods

The ACS-NSQIP database (2008–2022) was queried to identify adult female patients who underwent elective breast reduction. Preoperative, intraoperative, and postoperative parameters, including 30-day complications, were assessed. Multivariable logistic regression was used to evaluate the impact of operative time on postoperative outcomes, analyzing it as both a continuous and dichotomous variable.

Results

A total of 45,143 patients were included. Overall complications occurred in 6.4% (n=2870), with reoperation required in 1.8% (n=825) and readmission in 1.1% (n=516). Surgical complications were observed in 4.3% (n=1930), primarily superficial incisional infections (n=1466, 3.2%). Multivariable analysis demonstrated a nuanced association between operative time and complications: For every 1-h increase in operative time, the risk of any complication and surgical complications decreased by 11.4% (OR=0.998, p<0.0001) and 17.4% (OR=0.997, p<0.0001), respectively, whereas the risk of medical complications increased by 19.2% (OR=1.003, p=0.0009). Threshold analyses revealed that operative times >145 min and >147 min were associated with a significantly lower risk of any (OR=0.792, p<0.0001) and surgical complication (OR 0.708, p<0.0001), respectively. Conversely, operative times >156 min correlated with significantly higher odds of medical complications (OR=1.473, p=0.005).

Conclusion

Operative time impacts postoperative outcomes in breast reduction surgery. Longer procedures are linked to lower surgical risks but higher medical complications. Further research is needed to validate these findings and explore the underlying mechanisms.

虽然延长手术时间会增加其他手术的风险，但其对缩胸效果的影响尚不清楚。本回顾性队列研究探讨了缩乳手术时间与术后发病率的关系。方法查询ACS-NSQIP数据库（2008-2022）中择期行缩乳手术的成年女性患者。评估术前、术中和术后参数，包括30天并发症。采用多变量logistic回归评估手术时间对术后预后的影响，将其作为连续变量和二分类变量进行分析。结果共纳入45143例患者。总并发症发生率为6.4% (n=2870)，再次手术发生率为1.8% (n=825)，再入院发生率为1.1% （n=516）。手术并发症发生率为4.3% (n=1930)，主要为浅表切口感染（n=1466, 3.2%）。多变量分析显示手术时间与并发症之间存在微妙的关联：手术时间每增加1小时，任何并发症和手术并发症的风险分别降低11.4% （OR=0.998, p= 0.0001）和17.4% (OR=0.997, p= 0.0001)，而内科并发症的风险增加19.2% （OR=1.003, p=0.0009）。阈值分析显示，手术时间145分钟和147分钟与任何手术并发症（OR=0.792, p<0.0001）和手术并发症（OR= 0.708, p<0.0001）的风险显著降低相关。相反，手术时间156 min与较高的并发症发生率相关（OR=1.473, p=0.005）。结论缩胸手术时间影响手术效果。手术时间越长，手术风险越低，但并发症也越多。需要进一步的研究来验证这些发现并探索潜在的机制。

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引用次数: 0

Lymphatic ultrasound detects more vessels than indocyanine green lymphography in lymphedematous limbs 淋巴超声在四肢淋巴水肿中比吲哚菁绿淋巴造影发现更多的血管

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-07 DOI: 10.1016/j.bjps.2025.11.005

Hisako Hara , Makoto Mihara

Background

Indocyanine green (ICG) lymphography is widely used for preoperative assessment in lymphaticovenous anastomosis; however, its limited imaging depth and inability to detect vessels with impaired flow may lead to underestimation of surgical targets. Lymphatic ultrasound is a noninvasive, contrast-free modality capable of visualizing deeper lymphatic vessels and providing structural assessment. This retrospective study compared lymphatic ultrasound and ICG lymphography for detecting lymphatic vessels in patients with lower limb lymphedema.

Methods

Thirteen female patients (26 limbs; 104 areas) underwent both ICG lymphography and lymphatic ultrasound preoperatively. Each limb was divided into four regions (lateral thigh, medial thigh, medial calf, and lateral calf). The number of lymphatic vessels identified by each modality was recorded per region, and analyses were stratified by dermal backflow (DB) status on ICG lymphography.

Results

Overall, lymphatic ultrasound identified significantly more lymphatic vessels than ICG lymphography (mean ± SD: 1.9 ± 1.5 vs. 0.6 ± 0.7 vessels per area, p < 0.01). In DB-positive areas, ultrasound detected more vessels (1.9 ± 1.5) than ICG (0.3 ± 0.5, p < 0.01). In DB-negative areas also, ultrasound identified more vessels (2.0 ± 1.5) than ICG (1.1 ± 0.9, p < 0.01), except in the DB-negative lateral calf, where ICG detected more vessels. Across all the International Society of Lymphology stages, ultrasound identified more vessels; in stage 3, no vessels were detected using ICG, whereas ultrasound detected an average of 2.4 vessels per area.

Conclusions

Lymphatic ultrasound detects more lymphatic vessels than ICG lymphography, particularly in DB-positive regions and advanced stages. Negative ICG findings did not necessarily indicate the absence of lymphatic vessels. The combined use of ultrasound and ICG lymphography may broaden lymphaticovenous anastomosis eligibility and enhance preoperative planning.

背景：ICG淋巴造影术广泛应用于淋巴-静脉吻合术的术前评估；然而，它的成像深度有限，无法检测到血流受损的血管，这可能导致对手术目标的低估。淋巴管超声是一种无创、无造影剂的检查方式，能够显示更深的淋巴管并提供结构评估。本回顾性研究比较了淋巴超声和ICG淋巴造影在下肢淋巴水肿患者中检测淋巴管的效果。方法13例女性患者（26条肢体，104个部位）术前行ICG淋巴造影和淋巴超声检查。每条肢体分为四个区域（大腿外侧、大腿内侧、小腿内侧和小腿外侧）。记录每个区域通过每种方式识别的淋巴管数量，并根据ICG淋巴造影上的真皮回流（DB）状态进行分层分析。结果总体而言，淋巴超声比ICG淋巴造影发现更多的淋巴管（平均±SD: 1.9±1.5 vs. 0.6±0.7,p < 0.01）。在db阳性区，超声检出的血管数（1.9±1.5）比ICG检出的血管数（0.3±0.5,p < 0.01）多。在db阴性区域，超声也比ICG（1.1±0.9,p < 0.01）发现更多的血管（2.0±1.5），但在db阴性的小腿外侧，ICG检测到更多的血管。在国际淋巴学会的所有阶段，超声检查发现了更多的血管；在第3阶段，ICG未检测到血管，而超声平均每个区域检测到2.4条血管。结论淋巴超声比ICG淋巴造影检出更多的淋巴管，特别是在db阳性区和晚期。ICG阴性结果并不一定表明没有淋巴管。超声和ICG淋巴造影的联合应用可以拓宽淋巴-静脉吻合术的资格，加强术前规划。

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引用次数: 0

Perfusion control of the nipple-areola complex in reduction plasty for gigantomastia using indocyanine green: A prospective observational study 吲哚菁绿对巨乳症缩成形术中乳头-乳晕复合体灌注控制的前瞻性观察研究

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-07 DOI: 10.1016/j.bjps.2025.11.008

Marc Daniels , Robert Jonathan Musmann , Christoph Andree , Beatrix Munder , Mazen Hagouan , Dirk Janku , Sonia Fertsch , Andreas Wolter

Introduction

Reduction mammaplasty in patients with severe macromastia poses technical challenges. In cases involving large resection volumes and long distances between the sternal notch and nipple, the risk of postoperative perfusion disturbance in the nipple-areola complex (NAC) is significantly increased. Indocyanine green (ICG) angiography has proven helpful in numerous clinical applications and can support the objective assessment of tissue perfusion which is particularly helpful in situations where vascularization is compromised, such as extreme volume reductions. We investigated whether ICG angiography can reliably detect areas of hypoperfusion, help prevent postoperative NAC necrosis and serve as a reliable decision-making tool.

Patients and methods

This prospective observational study was conducted between August 2023 and May 2025. All procedures were performed using the Double-Unit Superomedio-Central Pedicle technique. The study included adult patients with a sternal notch (SN)-to-nipple distance >35 cm. Subsequently, ICG angiography was employed to assess real-time perfusion of the NAC.

Results

The analysis included a total of 21 patients (42 breasts). The mean age of these patients was 46.3 ± 12.7 years (range 26–70 years). The mean body mass index was 31.6 ± 5.9 kg/m². The average SN-NAC distance was 40.4 ± 4.1 cm on the right and 39.6 ± 3.7 cm on the left. In this patient cohort, no necrosis of the NAC occurred, even in cases involving breasts with SN-NAC distances exceeding 50 cm and high resection weights.

Conclusion

Intraoperative ICG fluorescence angiography represents a promising tool to support surgical decision-making in reduction mammaplasty.

重度巨乳症患者的缩乳成形术存在技术上的挑战。在切除体积大且胸骨切迹与乳头之间距离较长的病例中，术后乳头-乳晕复合物（NAC）灌注紊乱的风险显著增加。吲哚菁绿（ICG）血管造影已被证明在许多临床应用中是有用的，并且可以支持客观的组织灌注评估，这在血管化受损的情况下特别有用，例如极度体积缩小。我们研究了ICG血管造影是否可以可靠地检测灌注不足区域，帮助预防术后NAC坏死，并作为可靠的决策工具。患者和方法本前瞻性观察性研究于2023年8月至2025年5月进行。所有手术均采用双单元上正中椎弓根技术。该研究包括胸骨切迹（SN）到乳头距离35cm的成年患者。随后，采用ICG血管造影评估NAC的实时灌注情况。结果共纳入21例患者（42个乳房）。这些患者的平均年龄为46.3±12.7岁（范围26-70岁）。平均体重指数为31.6±5.9 kg/m²。平均SN-NAC距离为右侧40.4±4.1 cm，左侧39.6±3.7 cm。在该患者队列中，即使在SN-NAC距离超过50 cm且切除重量较大的乳房中，也未发生NAC坏死。结论术中ICG荧光血管造影是一种很有前途的工具，可以支持乳房缩小成形术的手术决策。

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引用次数: 0

Nine factors influencing breast ptosis following reduction mammoplasty 影响缩乳术后乳房下垂的九个因素

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery

Pub Date : 2025-11-06 DOI: 10.1016/j.bjps.2025.11.003

Marco Gratteri , Giovanni Francesco Marangi , Fara Desiree Romano , Felicia Geanina Grosu , Daniela Porso , Andrea Tarantino , Luigi Abate , Riccardo De Bernardis , Annalisa Cogliandro , Paolo Persichetti

Introduction

Ptosis is a common complication after reduction mammoplasty, but its main influencing factors remain unclear. We aimed to evaluate the roles of age, smoking, pregnancies, hypertension, diabetes, preoperative glandular composition, stretch marks, Fitzpatrick skin type, weight change, Ribeiro flap usage, resected tissue weight, and preoperative and postoperative breast volume on breast droop within the first year after surgery.

Materials and methods

Overall, 127 women who consecutively underwent reduction mammoplasty within 3 years took part in this study. Previously cited recorded data were noted and exported in Prism10 for correlation analysis with two indexes of breast ptosis: sternal notch-nipple and nipple-inframammary fold T12-T1 deltas.

Results

For breast ptosis, the major influencing positive factors were age, postsurgery breast volume, stretch mark score, estimated preoperative major glandular composition of the breast, and delta weight. Smoking history and diabetes mellitus correlate in a moderate manner. Pregnancy weakly positively correlated with breast ptosis, whereas preoperative breast volume, resected breast weight, and Fitzpatrick skin type did not correlate with the investigated indexes. The only factor that negatively correlated with breast ptosis indexes was the usage of Ribeiro flap.

Conclusion

Breast ptosis after reduction mammoplasty is strongly correlated with age, postsurgery breast volume, stretch mark score, estimated preoperative major glandular composition of the breast, and delta weight in the first year after surgery. Other influencing factors were smoking history, diabetes mellitus, and history of pregnancy. The Ribeiro flap proved to have a protective role.

上睑下垂是缩乳术后常见的并发症，其主要影响因素尚不清楚。我们的目的是评估年龄、吸烟、怀孕、高血压、糖尿病、术前腺体组成、妊娠纹、Fitzpatrick皮肤类型、体重变化、Ribeiro皮瓣使用、切除组织重量、术前和术后乳房体积对术后一年内乳房下垂的影响。材料和方法总共有127名在3年内连续接受乳房缩小术的女性参与了本研究。在Prism10中记录之前引用的记录数据并导出，与胸骨缺口-乳头和乳头-乳下褶T12-T1 delta两个乳房下垂指标进行相关性分析。结果乳房下垂的主要影响因素为年龄、术后乳房体积、妊娠纹评分、术前乳房主要腺体组成和体重。吸烟史与糖尿病有中度相关性。妊娠与乳房下垂呈弱正相关，而术前乳房体积、切除乳房重量和Fitzpatrick皮肤类型与所调查的指标无关。唯一与乳房下垂指数呈负相关的因素是Ribeiro皮瓣的使用。结论缩乳术后乳房下垂与年龄、术后乳房体积、妊娠纹评分、术前乳房主要腺体组成及术后1年体重密切相关。其他影响因素包括吸烟史、糖尿病和妊娠史。里贝罗皮瓣被证明具有保护作用。

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引用次数: 0