CAJ | 학술논문

目的：探讨组织扩张后使用假体进行乳房再造过程中，可使两侧乳房对称的方法。方法2006年6月至2014年6月，对48例患者行组织扩张后假体乳房再造，在再造过程中采用对称性处理，方法包括：①选择直径与健侧乳房基底直径相近的扩张器，对称位置埋置，下极位置低于对称下皱襞2~3 cm，超量注水扩张；②依据扩张器注水容积，模拟假体容量及健侧乳房的三维摄像数据选择大小、形态适合的假体；③采用包括患侧的自体颗粒脂肪注射移植、背阔肌肌瓣移植、乳头乳晕移位，健侧乳房缩小、假体置入增大、上提固定等对称性修整手术。结果本组患者术后随访6~48个月，平均11.9个月。术后双侧乳房均达到基本对称，患者对再造效果满意。结论对乳房准确的测量，选择合适的扩张器，置入恰当的假体，结合两侧适当的修整，可以获得对称的再造效果。
목적：탐토조직확장후사용가체진행유방재조과정중，가사량측유방대칭적방법。방법2006년6월지2014년6월，대48례환자행조직확장후가체유방재조，재재조과정중채용대칭성처리，방법포괄：①선택직경여건측유방기저직경상근적확장기，대칭위치매치，하겁위치저우대칭하추벽2~3 cm，초량주수확장；②의거확장기주수용적，모의가체용량급건측유방적삼유섭상수거선택대소、형태괄합적가체；③채용포괄환측적자체과립지방주사이식、배활기기판이식、유두유훈이위，건측유방축소、가체치입증대、상제고정등대칭성수정수술。결과본조환자술후수방6~48개월，평균11.9개월。술후쌍측유방균체도기본대칭，환자대재조효과만의。결론대유방준학적측량，선택합괄적확장기，치입흡당적가체，결합량측괄당적수정，가이획득대칭적재조효과。
Objective To explore different techniques for bilateral symmetry in breast reconstruction with implant after tissue expansion. Methods From June 2006 to June 2014, 48 patients received breast reconstruction with implant after tissue expansion. The following symmetrization procedures were used during breast reconstruction. (1) Expander was chosen according to controlateral size and was placed 2 to 3 cm lower than controlateral IMF and then over-expand. (2) The implant was chosen according to the expander, the sizer or the data from 3D photography. (3) Ipsolateral fat transfer, latissimus dorsi muscle flap transplantation, NAC transposition, and contralateral breast reduction, mastopexy, augmentation were used for symmetrization. Results All the patients were followed up for 6 to 48 months, mean 11.9 months. Bilateral symmetry were achieved through these procedures and all patients were satisfied with the results. Conclusion Accurate measurement of the breast, the appropriate choice of the expander and implant, and symmetrization procedures of both side are necessary for better symmetry in breast reconstruction.