Plastiche mammarie per ipertrofia e ptosi: tecniche - 21/07/25

[45-662] - Doi : 10.1016/S1769-6704(25)50857-4

C. Bruant-Rodier : Professeur des Universités, F. Bodin : Professeur des Universités, C. Dissaux : Praticien hospitalier
Service de chirurgie plastique, esthétique et reconstructrice, Hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France

Riassunto

Dopo aver descritto tappa dopo tappa le basi del processo tecnico delle mammoplastiche, sono presentate 15 tecniche. Esse sono descritte, passo dopo passo, in maniera parallela, per consentire confronti e per trarre indicazioni. Evoluzione, complicanze e problemi particolari chiudono questo articolo.

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Parole chiave : Ipertrofia mammaria, Ptosi mammaria, Mammoplastica riduttiva, Cicatrice, Peduncolo

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Introduzione

Diverse tecniche chirurgiche

Tecnica di Pitanguy ^{[Pitanguy I. Une nouvelle technique de plastie mammaire. Étude de 245 cas consécutifs et présentation d'une technique personnelle Ann Chir Plast 1962 ; 7 : 199-208

, Pitanguy I. Surgical treatment of breast hypertrophy Br J Plast Surg 1967 ; 20 : 78-85

]} ()

Tecnica di Weiner ^{[Weiner D.L., Ariache A.E., Silver R., Tittis T. A single dermal pedicle for nipple transposition in subcutaneous mammoplasty or mastopexy Plast Reconst Surg 1973 ; 51 : 115-120

, Weiner D.L., Dolich B.H., Miclat M.I. Reduction mammoplasty utilizing the superior pedicle technique: a six years retrospective Aesthetic Plast Surg 1982 ; 6 : 1-7

]} ()

Tecnica dell'arco dermico ^{[Lalardrie J.P., Mitz V. Plastie mammaire de réduction par la technique de la voûte dermique J Chir 1974 ; 108 : 57-68

, Lalardrie JP, Jouglard JP. Chirurgie plastique du sein. Rapport de la Société française de chirurgie plastique reconstructrice et esthétique. Paris: Masson; 1974.

]} ()

Tecnica della cicatrice verticale ^{[Lassus C. Breast reduction. Evolution of a technique. A single vertical scar Aesthetic Plast Surg 1987 ; 11 : 107-112

, Lejour M. Vertical mammoplasty and liposuccion on the breast Plast Reconstr Surg 1994 ; 94 : 100-114

, Lassus C. A 30 years-experience with vertical mammoplasty Plast Reconstr Surg 1996 ; 97 : 373-380

, Lejour M., Abboud M. Vertical mammoplasty without inframammary scar and with breast liposuccion Perspect Plast Surg 1996 ; 4 : 67-90

, Lassus C. Update on vertical mammoplasty Plast Reconstr Surg 1999 ; 104 : 2289-2298

, Lejour M. Vertical mammoplasty. Update and apparaisal of late results Plast Reconstr Surg 1999 ; 104 : 771-784

]} ()

Tecnica di Saint-Louis ^{[Bricout N., Groslieres D., Servant J.M., Banzet P. Plastie mammaire : la technique utilisée à Saint-Louis Ann Chir Plast Esthet 1988 ; 33 : 7-15

]} ()

Tecnica della mammella residua ^{[Chavoin J.P., Rouge D., Fradin-Joly N., Elkhollali R., Costagliola M. “Remaining breast”: technique for hypertrophic and asymetric breast. Transactions of the Xth International Congress of Plastic and Reconstructive Surgery Madrid: Elsevier Science Publishers BV (1992). 631-637

]} ()

Tecnica di Strombeck ^{[Strombeck J.O. Mammoplasty: report of a new technique based on the two pedicle procedure Br J Plast Surg 1960 ; 13 : 79-90

, Strombeck J.O. Macromastia in women and its surgical treatment Acta Chir Scand suppl 1964 ; 341 : 1-128

]} ()

Tecnica di Skoog - variante interna ^{[Skoog T. A technique of breast reduction. Transposition of the nipple on a cutaneous vascular pedicle Acta Chir Scand 1963 ; 126 : 453-465

, Hauben D.J. Experience and refinements with the supero-medial dermal pedicle for nipple-areola transposition in reduction mammoplasty Aesthetic Plast Surg 1984 ; 8 : 189-194

, Finger R.E., Vasquez B., Drew G.S., Given K.S. Superior medial pedicle technique for reduction mammoplasty Plast Reconstr Surg 1989 ; 83 : 471-480

]} ()

Tecnica a peduncolo interno e cicatrice verticale ^{[Hall Findlay E. A simplified vertical reduction mammoplasty shortening the learning curve Plast Reconstr Surg 1999 ; 104 : 748-759

, Hall Findlay E. Vertical breast reduction with a medially based pedicle Aesthetic Surg J 2002 ; 22 : 185-194

]} ()

Tecnica di Mac Kissock ^{[McKissock P.K. Reduction mamoplasty with a vertical dermal flap Plast Reconstr Surg 1972 ; 49 : 245-252

, McKissock P.K. Correction of macromastia by bipedicle vertical dermal flap Plastic and reconstructive surgery of the breast Boston: Little Brown (1976).

]} ()

Tecnica a peduncolo inferiore ^{[Ribeiro L. A new technique for reduction mammoplasty Plast Reconstr Surg 1975 ; 55 : 330-334

, Robbins T.H. A reduction mammoplasty with the areola-nipple based on an inferior pedicle Plast Reconstr Surg 1977 ; 59 : 64-67

, Courtiss E., Goldwyn R. Reduction mammaplasty by the inferior pedicle technique: an alternative to free nipple and areolar grafting for severe macromastia or extreme ptosis Plast Reconstr Surg 1977 ; 59 : 500-507

, Reich J. The advantages of a lower central breast segment in reduction mammoplasty Aesthetic Plast Surg 1979 ; 3 : 47

, Georgiade N.G., Serafin D., Reifkohl R., Georgiade G.S. A technique utilizing the inferiorly based dermal nipple areola flap Ann Plast Surg 1979 ; 3 : 106-110

, Amar R., Bosch Del Marco G. Plastie mammaire de réduction utilisant un lambeau dermoglandulaire à pédicule inférieur Ann Chir Plast 1981 ; 26 : 243-247

, Moufarrège R., Muller G.H., Beauregard G., Bosse J.P., Parillon J. Plastie mammaire à pédicule dermoglandulaire inférieur Ann Chir Plast 1982 ; 27 : 249-254

, Moufarrège R., Beauregard G., Bosse J.P., Muller G., Papillon J., Perras C. Reduction mammoplasty by the total dermoglandular pedicle Aesthetic Plast Surg 1985 ; 9 : 227-232

, Hammond D., Alfonso D., Khuthaila D. Mastopexy using the short scar periareolar inferior pedicle reduction technique Plast Reconstr Surg 2008 ; 121 : 1533-1539

]} ()

Tecnica a peduncolo posteriore ^{[Climo M.S., Alexander J.E. Intercostothelial circulation nipple survival in reduction mammoplasty in absence of dermal pedicle Ann Plast Surg 1980 ; 4 : 128

, Trepsat F. La réduction mammaire par pédicule postéro-inférieur glandulaire sans désépidermisation Ann Plast Surg 1980 ; 36 : 18-22

, Bolger W.E., Seyfer A.E., Jackson S.M. Reduction mammoplasty using the inferior glandular pyramid pedicle: experience with 300 patients Plast Reconstr Surg 1987 ; 80 : 75

, Levet Y. The pure posterior pedicule procedure for the breast reduction Plast Reconstr Surg 1990 ; 86 : 67-75

]} ()

Tecnica di Benelli (1989) ^{[Benelli L. Technique de plastie mammaire : le round block Rev Chir Esthet 1989 ; 50 : 13

, Benelli L. A new periareolar mammoplasty: “the round block” technique Aesthetic Plast Surg 1990 ; 14 : 93-100

]} ()

Tecnica della porta carraia ^{[Peixoto G. Reduction mammoplasty: a personal technic Plast Reconstr Surg 1980 ; 65 : 217-225

, Marchac D., De Olarte G. Reduction mammoplasty and correction of ptosis with a short infra-mammary scar Plast Reconstr Surg 1982 ; 69 : 45-55

, Peixoto G. The infra-areolar longitudinal incision in reduction mammoplasty Aesthetic Plast Surg 1985 ; 9 : 1-5

, Marchac D., Sagher U. Mammoplasty with a short horizontal scar. Evolution and results after 9 years Clin Plast Surg 1988 ; 15 : 627

]} ()

Tecnica di Thorek ^{[Thorek M. Possibilities in the reconstruction of the human forme NY Med J Med Rec 1922 ; 116 : 572

, Thorek M. Plastic surgery of the breast and abdominal wall Springfield: CC Thomas (1942).

, Thorek M. 25 years-experience with plastic reconstruction of the breast and transplantation of the nipple Am J Surg 1945 ; 67 : 445

, Gradinger G.P. Reduction mammoplasty utilizing nipple-areola transplantation Clin Plast Surg 1988 ; 15 : 641

, Casas L.A., Byun M.Y., Depoli P.A., Gradinger G.P. Maximizing breast projection after free-nipple-graft reduction mammoplasty Plast Reconstr Surg 2001 ; 107 : 961-964

]} ()

Indicazioni e scelta di una tecnica

Complicanze e loro gestione

Necrosi della placca areola-capezzolo

Ematoma

Infezione

Deiscenza ampia delle suture

Ritardo di cicatrizzazione limitato

Cicatrici cheloidi

Questioni varie

Dolorabilità del capezzolo

Mastoplastica riduttiva e gestione

Soddisfazione postoperatoria

Conclusioni

Esportazione

Articolo precedente

Plastiche mammarie per ipertrofia e ptosi: principi generali
C. Bruant-Rodier, F. Bodin, C. Dissaux

| Articolo seguente

Chirurgia dell'ipotrofia mammaria
F. Bodin, A. Auque, E. Ramelli, L. Dibiase, C. Bruant-Rodier, L. Ruffenach

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Plastiche mammarie per ipertrofia e ptosi: tecniche - 21/07/25

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