METHOD FOR SURGICAL CORRECTION OF BREAST PTOSIS Russian patent published in 2022 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to plastic surgery. Preoperative marking of the axis of the mammary gland, the upper border of the glandular tissue of the mammary gland is applied. The new position of the nipple-areolar complex is indicated by placing the index finger in the submammary fold and marking the projection of its tip on the anterior surface of the mammary gland along the axis of the mammary gland. The vertical borders of breast skin flap reduction, the borders of de-epidermization of the lower-central feeding pedicle, the boundaries of the mobilization of the glandular flap, as well as the boundaries of the retromammary mobilization of the upper dermo-glandular flap are marked and the deep-epidermization of the lower-central feeding pedicle is performed while maintaining the nipple-areolar complex with a diameter of 4.5-5 cm. Then, a subcutaneous dissection of the skin pocket is performed in stages with cutting out a hemispherical glandular flap around the perimeter to the fascia of the pectoralis major muscle. The glandular flap is mobilized along the upper semicircle at the level of the II-III intercostal space from the fascia of the pectoralis major muscle retromammarily to the border of the horizontal fibrous septum with preservation of the medial and lateral ligaments located at the level of the IV intercostal space. The upper dermoglandular flap of the mammary gland is mobilized in the projection of the upper contours cranially, cranio-medially and cranio-laterally by 2-4 cm to the level of the second rib. Then, the first row of interrupted non-absorbable sutures is applied between the fascia of the pectoralis major muscle and the horizontal fibrous septum, of which the first suture is placed at the level of the intersection of the axis of the mammary gland and the III intercostal space, the second and third sutures are placed at a distance of 2 cm from the first lateral and medial along the III intercostal space. The second row of non-absorbable sutures is placed between the upper edge of the glandular flap and the fascia of the pectoralis major muscle, while the first suture is placed at the level of the intersection of the axis of the mammary gland and the II intercostal space, the second and third sutures are placed at a distance of 2 cm from the first laterally and medially at the level of the II intercostal space, the fourth and fifth sutures at a distance of 2 cm from the previous sutures at the level of the III intercostal space. The third row of non-absorbable sutures is used to fix the lower-central pedicle to the fascia of the pectoral muscles at the level of the IV intercostal space, while the lower-central pedicle is plicated without disturbing the blood supply to the glandular flap. Next, layer-by-layer suturing of the vertical and horizontal fragments of the surgical wound is carried out. The position of the nipple-areolar complex is marked, which is fixed with interrupted long-term absorbable sutures and then an intradermal suture of the "T-inverse" type is applied in combination with a circumareolar suture.

EFFECT: method makes it possible to securely fix the movable glandular flap, achieve long-term filling of the upper contour of the remodeled mammary gland, and thereby prevent recurrence of breast ptosis.

1 cl, 12 dwg, 2 ex