ResumenLas mamas tuberosas, denominadas así por Rees y Aston, y también llamadas hernias del complejo areolar (Bass), Snoopy deformity (Gruber), mamas tubulares (Williams), hipoplasia del polo inferior (Brink) o mamas de base estrecha (Puckett), son una malformacion en el desarrollo del volumen mamario en los cuadrantes inferiores con hernia areolar secundaria (placa areolar y mús-culo mamilar débiles), areola ancha y protruida (en la mitad de los casos), ascenso del surco submamario, mamas hipotróficas y raramente hipertróficas, con asimetrías en las dos terceras partes de las pacientes.Presentamos la estrategia quirúrgica adecuada para resolver esta patología utilizando solo implantes anatómi-cos de gel cohesivo sin necesidad de tallar colgajos glandulares. De esta manera, disminuimos la morbilidad quirúrgica, ofreciendo resultados estables y con alta satisfaccion por parte de las pacientes.
Palabras clave Mama tuberosa,Aumento mamario, Implantes mamarios. Código numérico 5246-5211-52114
AbstractTuberous breasts, denominated like this by Rees and Aston, and also called areolar complex hernia by Bass, Snoopy deformity by Gruber, tubular breasts by Williams, inferior pole hypoplasia by Brink, tight base breasts by Puckett, are a malformation of breast with inferior quadrants alteration that produce an areolar herniation and protrusion (in fifty per cent of the cases), and elevation of the infamammary fold; they are rarely hypertrophic and with asymmetries in two thirds of the patients.Authors present the surgical strategy to solve this pathology just using high cohesive silicone gel anatomical implants without needing of glandular flap tailoring. By this way, surgical morbidity is diminished offering stable results and high patient satisfaction.
Summary:Women desire beautiful breasts that are functional, pain free, and without foreign material. Vertical scars, insufficient elevation, inadequate upper pole fullness, nipple numbness, and loss of breast feeding are undesirable. Relieving pain attributed to enlarged breasts has required significant tissue removal. Software analysis of chest images, physical measurements, and desires are combined to generate a surgical blueprint. The breast is divided horizontally into two components preserving the neurovascular supply and major lactiferous ducts. The skin flap cephalad to the areola provides external coverage. The areola remains attached to a deepithelialized mound, which is rotated into a cone. Dermal straps originating from the base of the cone are looped through the pectoralis major muscle and the cone repeatedly. Weight transfer to the pectoralis major muscles eliminates pain in 54% and decreases pain in 38%. Incisions are concealed at the areola cutaneous junction and in the shadow of the breast. Upper pole fullness increased in 86% without implants or fat transfer. Nipple sensation was increased in 37% and unchanged in 44%. Overall results were excellent in 50% and good in 36%. Complications consisted of dog-ears, periareolar infection, and fat necrosis. No patient required a return to the operation room. Combing computer-aided design with plastic surgical principles creates beautiful, functional breasts without foreign material. Vertical scars are avoided, and weight transfer relieves pain.
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