FIELD: medicine.
SUBSTANCE: invention relates to breast surgery. Method involves removal of multiple benign breast growths through a single approach, correction of an upper slope of a ptosis mammary gland with a hemispherical glandular flap without using a silicone implant. During the preoperative ultrasound-guided marking, the locations of multiple new growths in the mammary gland parenchyma are determined, axis of mammary gland, putative upper border of remodeled mammary gland, new position of nipple-areola complex, borders of cut out hemispherical glandular flap and zone of de-epidermisation of inferior central dermoglandular pedicle. After de-epidermisation and cutting out of inferior central pedicle with preservation of nipple-areola complex with diameter of 4.5–5 cm, subcutaneous dissection of skin-fat flaps, removal of multiple new growths through a single approach, a hemispherical glandular flap is cut out and its mobilization along upper semicircle at level of II–III intercostal space from fascia of greater pectoral muscle retromammary with preservation of horizontal fibrous septum, medial and lateral ligaments. Further, an upper dermoglandular breast flap is mobilized in a retromammary space from a greater pectoral muscle in a projection of the upper contours by 2–4 cm cephalad, cranio-lateral and cranio-medial from the previously marked upper border, after which the hemispherical glandular flap is fixed with interrupted non-absorbable sutures to the greater pectoral muscle. First row of non-absorbable sutures is applied along upper edge of hemispherical glandular flap, second row of non-absorbable sutures between lower pedicle and fascia of pectoral muscles. Further, the mammary gland flaps are closed by T-inversion type, and the nipple-areola complex is fixed in the previously marked new position.
EFFECT: method enables eliminating the risk of malignancy of breast new growths, achieving a long-term aesthetic result as a result of breast remodeling by multilevel fixation of hemispherical glandular flap with preservation of adequate filling of upper breast contour without using silicone implant, neurovascularisation of the nipple-areola complex and lactating function of the mammary gland.
1 cl, 1 ex, 16 dwg
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Authors
Dates
2024-03-21—Published
2023-04-10—Filed