乳腺中心蒂乳房肥大缩小术

目的 探寻一种保证乳房肥大缩小手术后乳头乳晕的良好血运和感觉及哺乳功能、并减少手术并发症的术式。方法 选择乳头乳晕深部中心区的乳腺组织做乳头乳晕蒂，蒂中包含支配乳头乳晕的乳腺中央支血管、感觉神经，术中一直可观察到刺激乳头后的勃起反应，并使中心区保留的乳腺组织与乳头间有输乳管相连，以保留该部的哺乳功能。术中切除多余的乳腺及相应脂肪组织，缩小后的乳房容易塑形。结果 自1996年开展此项手术以来，共已完成17例，无1例发生乳头乳晕的并发症，感觉正常，并有1例曾经历哺乳。结论 乳腺中心蒂乳房肥大缩小术，不但可以保证乳头乳晕的血运，而且可避免对感觉神经的损伤，保留部分哺乳功能，并获得良好形态。

Reduction mammoplasty by central pedicle flap transposition

Objective To explore a surgical procedure of reduction mammary plasty to assure the viability and sensory of the nipple-areolar complex (NAC) after transposition and to keep the lactiferous function partly. Methods Reduction was accomplished by using perforating vascular branches from the pectoralis major muscle and its fascia supplying the nipple and breast parenchyma instead of the subdermal plexus. The central vascular pedicle supplying the nipple-areola complex was preserved. And the sensory nerve of the NAC was not injured. The erection of the nipple could be observed in operation. Lactation was possible because of preservation of the lactiferous ducts. The technique had been used in 17 patients since 1996. Results The nipple-areola complex was safely transposed with great freedom, and the amount of resection was accurately adjusted for symmetry. No cases of nipple-areola complex sensory change occurred postoperatively in all 17 patients. Breast-feeding was possible at least in one patient after operation. Conclusion This method is ideal for the patients, which keeps the viability and sensory of the nipple-areolar complex and the function of lactation. In another case, the amount of resection is easily adjusted for symmetry.