脂肪筋膜瓣乳房整形-陈祖锦
合集下载
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
Add Your Company Sloga1n1
Adipofascial flap
2021/6/7
天津市肿瘤医院乳腺一科 陈祖锦
1
基于乳腺切除的量及手术相对难度将OPS分为两级
I级
Ⅱ级
乳腺组织切除量少于 20% 不需要切除多余皮 直接缝合无需乳房成 形术 适用于腺体致密的乳 房 不需要整形技术训练
• Lateral thoracodorsal flap • Thoracoepigastric flap • Intercostal artery perforator (ICAP)flap • Thoracodorsal artery perforator (TDAP) flap • Latissimus dorsi (LD) myocutaneous flap
7
Modified thoracodorsal adipofascial cutaneous flap
8
9
10
.A 27-year-old woman with breast cancer located in the upper-outer quadrant of the right breast (Case 2) . (A) A modified thoracodorsal adipofascial cutaneous flap was designed so that it could be harvested via an incision along the anterior axillary line and an additional back incision. (B)(C) Six months postsurgery. The bilateral incisions were inconspicuous from the anterior view
2
乳腺组织切除量在 20~50%之间 需要切除多余皮肤 基于乳房成形术 腺体致密或脂肪含量丰 富的乳房均适用 需要一定的专业整形技 术训练
保乳术后乳房整形
Volume Displacement 用残存乳腺组织 进行美学重塑
3
Volume Replacement
用非乳腺织进行 替代填充
Volume replacement techniques • Adipofascial flap
6
6-year-old lady with breast cancer located on upper outer-quadrant of the right breast (Case 2) . (A) A resected area of the breast with the gross margin as 3 cm and a C-shaped thoracodorsal adipofascial flap was marked before surgery. (B and C) 6 months post-surgery. The cosmetic result was excellent.
11
12
13
The local findings 1 year after the surgery
14
Free dermal fat graft (FDFG)
A 57-year-old patient with a slim body and non-ptotic breasts (case 2) (A) Preoperative findings; (B) An incision line was drawn in red across the nipple. A free dermal fat graft (FDFG) from the lower abdomen was implanted in the cylinder-shaped deformity in the central breast; (C) Four years after surgery.
4
Thoracodorsal adipofascial flap
Procedure for harvesting the C-shaped thoracodorsal flap and repair of the defect. (A) By the same skin incision upon the middle axillary line, we can do the partial resection of the breast, axillary lymph node dissection, and get the adipofascial flap. (B) A C-shaped thoracodorsal adipofascial flap was harvested after local resection of the breast and axillary lymph node dissection. (C) Attaching the fascia of the latissimus dorsi muscle to the adipose tissue makes the harvested tissue firm. (D) The flap is rotated to the medial side to fill the defect. We sometimes roll or gather it to reconstruct to the breast mound.
5
42-year-old lady with breast cancer located on upper outer-quadrant of the right breast (Case 1) (A) A resected area of the breast with the gross margin as 3 cm and a C-shaped thoracodorsal adipofascial flap was marked before surgery. (B and C) 6 months post-surgery. The deformity of both breast and donor site is inconspicuous.
Adipofascial flap
2021/6/7
天津市肿瘤医院乳腺一科 陈祖锦
1
基于乳腺切除的量及手术相对难度将OPS分为两级
I级
Ⅱ级
乳腺组织切除量少于 20% 不需要切除多余皮 直接缝合无需乳房成 形术 适用于腺体致密的乳 房 不需要整形技术训练
• Lateral thoracodorsal flap • Thoracoepigastric flap • Intercostal artery perforator (ICAP)flap • Thoracodorsal artery perforator (TDAP) flap • Latissimus dorsi (LD) myocutaneous flap
7
Modified thoracodorsal adipofascial cutaneous flap
8
9
10
.A 27-year-old woman with breast cancer located in the upper-outer quadrant of the right breast (Case 2) . (A) A modified thoracodorsal adipofascial cutaneous flap was designed so that it could be harvested via an incision along the anterior axillary line and an additional back incision. (B)(C) Six months postsurgery. The bilateral incisions were inconspicuous from the anterior view
2
乳腺组织切除量在 20~50%之间 需要切除多余皮肤 基于乳房成形术 腺体致密或脂肪含量丰 富的乳房均适用 需要一定的专业整形技 术训练
保乳术后乳房整形
Volume Displacement 用残存乳腺组织 进行美学重塑
3
Volume Replacement
用非乳腺织进行 替代填充
Volume replacement techniques • Adipofascial flap
6
6-year-old lady with breast cancer located on upper outer-quadrant of the right breast (Case 2) . (A) A resected area of the breast with the gross margin as 3 cm and a C-shaped thoracodorsal adipofascial flap was marked before surgery. (B and C) 6 months post-surgery. The cosmetic result was excellent.
11
12
13
The local findings 1 year after the surgery
14
Free dermal fat graft (FDFG)
A 57-year-old patient with a slim body and non-ptotic breasts (case 2) (A) Preoperative findings; (B) An incision line was drawn in red across the nipple. A free dermal fat graft (FDFG) from the lower abdomen was implanted in the cylinder-shaped deformity in the central breast; (C) Four years after surgery.
4
Thoracodorsal adipofascial flap
Procedure for harvesting the C-shaped thoracodorsal flap and repair of the defect. (A) By the same skin incision upon the middle axillary line, we can do the partial resection of the breast, axillary lymph node dissection, and get the adipofascial flap. (B) A C-shaped thoracodorsal adipofascial flap was harvested after local resection of the breast and axillary lymph node dissection. (C) Attaching the fascia of the latissimus dorsi muscle to the adipose tissue makes the harvested tissue firm. (D) The flap is rotated to the medial side to fill the defect. We sometimes roll or gather it to reconstruct to the breast mound.
5
42-year-old lady with breast cancer located on upper outer-quadrant of the right breast (Case 1) (A) A resected area of the breast with the gross margin as 3 cm and a C-shaped thoracodorsal adipofascial flap was marked before surgery. (B and C) 6 months post-surgery. The deformity of both breast and donor site is inconspicuous.