DİKEY İZLİ MEME KÜÇÜLTME YÖNTEMİ AŞIRI BÜYÜK MEMELERDE GÜVENLİ BİR İŞLEM MİDİR?

Year 2005, Volume: 6 Issue: 2, 9 - 13, 01.08.2005

Eray Copcu Nazan Sivrioğlu Çaghan Baytekin Banu Koç Şule Er

Abstract

Amaç: Dikey izli (vertikal skar) meme küçültme tekniği mevcut ameliyat teknikleri içinde sıklıkla kullanılanyöntemlerden biridir. Bu teknik, özellikle meme düzeltme ve çok büyük olmayan memelerin küçültülmesindepek çok cerrah tarafından başarı ile uygulanmaktadır. Ancak aşırı büyük memelerde özellikle dikey izin iyileşmeproblemleri ile ilgili olarak kullanımı tartışmalıdır. Bu tekniğe en iyi aday hasta elastik derisi olan, orta derecedehipertrofik (800 gr.dan az) ve yağ ve bez karışımından oluşan memelerdir.Yöntem: Bu çalışmada, 1000 gr.dan fazla miktarda doku rezeksiyonu yaptığımız toplam 11 hastadaki aşırı büyükmemelerde uyguladığımız dikey izli tekniğin erken ve geç dönem sonuçları sunulmuştur.Bulgular: Hastaların yaşları 20 ile 46 arasında değişmekte olup ortancası 32 idi. Eksize edilen doku miktarı 1000ile 1780 gr. arasında olup ortalaması 1322 gr. idi. Tüm hastalar aynı cerrahi ekip tarafından ameliyat edildiler.İzlem süresince olgularda erken dönemde iki komplikasyon gözlendi: parsiyel meme başı - areola nekrozu vehematom. Aşırı sigara içimi öyküsü olan nekrozlu hasta hipertrofik skar ile iyileşti. Uzun dönem sonuçlarındahastalarda herhangi bir komplikasyon gözlenmedi.Sonuç: Sonuç olarak dikey izli meme küçültme yönteminin, 1000 gr. dan fazla rezeksiyon yapılacak aşırı büyükmemelerde güvenli bir şekilde uygulanabileceği görüşündeyiz

Keywords

meme küçültme, komplikasyon, aşırı büyük meme

Is The Vertical Scar Mammaplasty a Safe Procedure for Reduction of Heavy Sized Breasts?

Abstract

Aim: The vertical scar mammaplasty is one of the most frequently performed operations among reduction mammoplasties. The technique has now been adopted by many surgeons for mastopexies and small reductions, but it has not been commonly used for large reductions because of the frequency of healing problems of the vertical scar. The best candidate for surgery is a patient with elastic skin, moderate hypertrophy (up to 800 g removed per breast), and a breast which is a mixture of fat and glandular tissue. Method: In this study, we present our late term results with vertical scar reduction mammaplasty in heavy sized breast with resection of 1000g or more per breast in eleven patients. Eleven patients with heavy sized 22 breasts in which more than 1000g of tissue was resected are evaluated. Results: Median age of the patients was 32 years (20-46 years) and the average amount of resected specimen was 1322g (1000-1780g) per breast. All patients were operated by the same team and senior surgeon. During the follow up period 2 major complications in the early period were observed: partial nipple-areola necrosis and hematoma. Secondary healing of a partial nipple areola necrosis in a heavy smoker patient resulted in periareolar hypertrophic scar. There were no late term complications. Conclusion: We think that the vertical mammaplasty technique can safely be applied to heavy breasts and large reductions over 1000 gr of tissue.

Keywords

reduction mammoplasty, complication, gigantomastia

References

• 1. Kerrigan CL, Collins ED, Striplin D, et al. The health burden of breast hypertrophy. Plast Reconstr Surg 2001;108:1591-6.
• 2. Chao JD, Memmel HC, Redding JF, Egan L, OdomLC, Casas LA. Reduction mammaplasty is a functionaloperation, improving quality of life in symptomatic women: A prospective, single-center breast reduction outcome study. PlastReconstr Surg 2002;110:1644-8.
• 3. Hoffman S. Reduction mammaplasty: A medicolegal hazard?AestheticPlast Surg 1987;11:113-5
• 4. Cruz-Korchin N, Korchin L. Vertical versus Wise pattern breast reduction: patient satisfaction, revision rates, and complications. Plast Reconstr Surg 2003,112:1573-78
• 5. Hidalgo DA, Elliot LF, Palumbo S, Casa L, Hammond D. Current trends in breast reduction. Plast Reconstr Surg 1999;104:806-8.
• 6. Behmand RA, Tang DH, Smith DJ Jr. Outcomes in breast reduction surgery. Ann Plast Surg 2000;45:575- 80.
• 7. Beer G.M, Spicher I,Cierpka K.A,MeyerV.E. Benefits and pitfalls of vertical scar breast reduction. J Br Plast Surg 2004;57:1219.
• 8. Lejour M. Vertical mammaplasty and liposuction of the breast. PlastReconst Surg 1994;94:100-114.
• 9. Behmand RA, Tang DH, Smith DJ Jr. Outcomes in breast reduction surgery. Ann Plast Surg 2000;45:575- 80.
• 10. Chadbourne EB, Zhang S, Gordon Mj, et al. Clinical outcomes in reduction mammaplasty: a systematic review and meta-analysis of published studies. Mayo ClinProc 2001;76:503-10.
• 11. Hoffman S. Reductionmammaplasty: a medicolegal hazard?AesthPlast Surg 1987;11.113-6.
• 12. Lötsch F. Über Hängebrustplastik Zentralbl Chir 1923;50:1241.
• 13. Dartigues L. Traitement chirurgical du prolapsus mammaire.Méd Intern 1924;32:281.
• 14. Arié G. Una nueva téchnica de mastoplasia. Rev Lat AmCir Plast 1957;3:22.
• 15. Lassus C. Breast reduction: Evolution of a technique-A single vertical scar. Aesthetic Plast Surg 1987;11:107- 10.
• 16. Marchac D, De Olarte G. Reduction mammaplasty and correction of ptosis with a short inframammary scar. PlastReconstr Surg 1982;69:15-17
• 17. Lejour M. Vertical mammaplasty: Early complications after 250 personal consecutive cases. Plast Reconstr Surg 1999;104:764-9
• 18. Hammond DC. Short scar periareolar inferior pedicle reduction (SPAIR) mammaplasty. Plast Reconst Surg 1999;103:890-4.
• 19. Spear SL, Howard MA. Evolution of the vertical reduction mammaplasty. Plast Reconst Surg 2003;112:855-9.
• 20. Hidalgo DA. Vertical mammaplasty. Plast Reconst Surg 2005;115:1179-97.
• 21. Deconinck C, de Greef C, Walravens C, Calteux N. Report of 243 vertical mammoplasties for very large, heavy breasts and/or severe ptosis. Ann Chir Plast Esthet 2002;47:623-32.
• 22. Kevin F, O'Grady BA, Thoma A, Dal Cin A. A comparison of complication rates in large and small inferior pedicle reduction mammaplasty. Plast Reconstr Surg 2005;115:736-9.
• 23. Pallua, N, Ermisch C. “I” Becomes “L”: Modification of vertical mammaplasty Plast Reconstr Surg 2003,111:1860-70