| 摘要 |
FIELD: medicine. ^ SUBSTANCE: axis line of mammary gland crossing the centre of collar bone (F), nipple and center of summammary fold (E) is marked, line of submammary fold is marked from parasternal axillary line to anterior axillary line, lower of mammary grand. A new location of areola is marked as a finger projection on the anterior surface of breast if it is placed in submammary fold on the axis line of mammary gland - point A, retreat of 2 cm from the bottom edge of areola and point B is marked, an oval that connects point (A) and point (B) and defines external borders of deepidermisation is lined, the line of submammary fold is devided into four equal parts, points (C) and (D) are put along outside the edges of the internal two quarters, and the boarder between them passes through the axis of mammary gland and point (E). Deepidermisation is carried out around nipple-areola complex, from the periphery to the area of deepidermisation within the hypoderm dissection is made to the upper quadrant to the second rib, and across the width - to medial and lateral sides per 3 cm, down to submammary fold and fixing stitches crossing the upper edge of deepidermised skin are put, the upper edge of gland self-tissue and fascia of pectoral muscle, with fixation gradually, that is correspondingly in point (G) - the cross point of the axis line of mammary gland and second intercostal space, in point (H) and point (I), located in 3 cm from medial and lateral points (G) along the second intercostal space; in lower quadrants of mammary gland in the triangle projection (B) (C) (D), self-tissue of mammary gland is knifed in the form of a sector with the top directed into the gland, a pocket is formed in retromammary space expanding from submammary fold up to the third rib, through slightly raised tissue of mammary gland polypropylene net, width of which is 6 cm, is fixed in the pocket by three stitches to fascia of pectoral muscles on the level of the third inter intercostals space in point N - in the cross point of the axis line of mammary gland and the third intercostals space, in points (J) and (K), placed in 2 cm from medial and lateral points (N) along the third intercostals space, the bottom part of self-tissue of the gland is cut down in the area of resection by separate stitches with formation of new submammary fold, polypropylene net exserted from the cut, gland tissue is knifed into two equal parts, width of which is per 3 cm, to the depth from the exserted edge to a new submammary fold, these parts are tightened up with the edges, glandular tissue is enfolded and put through hypoderma to the level of the forth intercostals space, fixed to fascia of pectoral muscles in point (L) - cross point of line around the breast and the forth intercostal space and in point (M) - cross point of parasternal axillary line and the forth intecostal space, the upper edge of nipple is fixed by separate stitch in point (A), skin around the nipple is cut down by purse-string subcuticular suture. ^ EFFECT: method allows stanching postsurgical period, excluding sinking down of lower quadrants of mammary gland, minimise risk of ptosis recurrence. ^ 3 dwg, 1 ex |
