摘要
目的探讨经腋皱襞脂肪抽吸联合乳晕下小切口治疗SimonⅢ度腺体脂肪型男性乳房发育症(GYN)的临床效果。方法回顾性分析2020年3月至2021年3月空军军医大学西京医院整形外科采用脂肪抽吸联合腺体切除治疗SimonⅢ度腺体脂肪型GYN患者的临床资料。术前对患者乳房进行磁共振检查,确定为腺体脂肪型GYN(腺体组织超过50%);于腋前皱襞做一长约1 cm的切口,通过此切口对乳房肥大区域的脂肪组织进行反复抽吸,直至达到满意的厚度;于乳晕下做长约1 cm的弧形切口,对残余的腺体组织进行切除,将乳晕切口对位缝合。术后对双侧乳头、乳晕血运、感觉及切口愈合情况等进行观察,并对双侧胸廓形态、切口瘢痕等进行随访。结果共纳入38例GYN患者,年龄18~35岁,体质量指数18.8~24.5 kg/m^(2),平均22.5 kg/m^(2)。术中单侧乳房脂肪抽吸量平均为150 ml(130~170 ml),腺体切除量平均为105 g(85~125 g),出血量平均约30 ml(15~75 ml)。术后肥大的乳房体积明显缩小,均无血肿、感染、乳头、乳晕区皮肤缺血坏死及感觉障碍等并发症发生,切口均一期愈合。随访3~6个月,双侧胸廓平整、对称、轮廓自然,切口隐蔽、瘢痕不明显。结论经腋皱襞脂肪抽吸联合乳晕下小切口治疗Simon Ⅲ度腺体脂肪型GYN,安全性高,术后胸部轮廓流畅、形态自然,瘢痕小而隐蔽,达到了较好的美学效果。
Objective To investigate the clinical effect of axillary fold liposuction combined with small subareolar incision in the treatment of Simon Ⅲ degree glandular fatty gynecomastia(GYN).Methods The clinical data of Simon Ⅲ degree glandular fatty GYN patients treated by liposuction combined with gland resection in the Department of Plastic Surgery,Xijing Hospital of Air Force Military Medical University from March 2020 to March 2021 were reviewed.The patient’s breasts were examined by magnetic resonance imaging before operation,and it was determined as glandular fatty type GYN(more than 50% of glandular tissue).A 1 cm long incision was made in the anterior axillary fold,through which the adipose tissue in the hypertrophy area of the breast was repeatedly aspirated until the satisfactory thickness was achieved.An arc-shaped incision with a length of about 1 cm was made under the areola,the residual gland tissue was removed,and the areola incision was sutured.After operation,the blood supply,sensation and wound healing of bilateral nipples and areola were observed,and the bilateral thorax morphology and wound scar were followed up.Results A total of 38 patients with GYN,aged 18-35 years,with a body mass index of 18.8-24.5 kg/m^(2),with an average of 22.5 kg/m^(2),were included.The average amount of fat aspirated from unilateral breast was 150 ml(130-170 ml),the average amount of gland excised was 105 g(85-125 g),and the average amount of bleeding was about 30 ml(15-75 ml).The volume of hypertrophic breast decreased significantly after operation,and there were no complications such as hematoma,infection,nipple,areolar skin ischemia and necrosis and sensory impairment.The incision healed in one stage.3-6 months follow-up showed that bilateral thoraxes were flat,symmetrical,with natural contour,concealed incision and no obvious scar.Conclusions The axillary fold liposuction combined with small subareolar incision is safe in the treatment of Simon Ⅲ degree glandular fatty GYN.The chest contour is smooth,the shape is natural,and the scar is small and hidden after operation,which achieves a good aesthetic effect.
作者
王钠
张兆祥
Wang Na;Zhang Zhaoxiang(Department of Plastic Surgery,Xijing Hospital of Air Force Military Medical University,Xi’an 710032,China)
出处
《中华整形外科杂志》
CSCD
2022年第6期647-652,共6页
Chinese Journal of Plastic Surgery
关键词
男子乳腺发育
小切口
脂肪抽吸
磁共振成像
外科手术
Gynecomastia
Minor incision
Liposuction
Magnetic resonance imaging
Surgical procedures,operative
