Foundational And Clinical Research Of Micromastia And Breast Hypertrophy

Research Objective: By observations on breast anatomical structure of femalecorpses, learn the layers, structures, blood supplies,innervations of the breasts, provideanatomical basis for the breast surgery. According to the aesthetic standards and TheBreast-Q survey, for the common breast morphological abnormalities of Chinesepeople,micromastia and breast hypertrophy, Discuss the functional and psychologicalimpact due to the morphological changes after surgery and the factors that influencesatisfaction.Research Methods:（1）Anatomical part Dissect the breast on the eight female corpses, identifythe general anatomy, the blood supply and innervations of the breasts.（2）Clinical part35cases with micromastia and16cases with breasthypertrophy had carried breast augmentation and reduction mammaplasty (vertical bi-pedicle breast reduction and double-loop breast reduction) respectively. Throughcomparing self satisfaction, physical well being, psychological well being, sexual wellbeing and other aspects of life changes preoperation and postoperation,evaluateoverall satisfaction after operations; discuss surgical indications, advantages anddisadvantages and operation points.Research Result:1、Anatomical part1.1The breast blood supply consists of the intercostal perforating branches ofinternal thoracic artery, lateral thoracic artery and thoracic acromial artery and thevertical perforating branches of intercostal arteries. The ercostal perforating branchesof internal thoracic artery, lateral thoracic artery and intercostal artery perforating branch all reach the nipple and areola areas.There are various vascular interconnectiontraffic branch between them.1.2The lateral branches and the anterior branches of the T2-T6intercostal nervesinnervate the breasts, The fourth interocostal nerve innervates constantly to thenipple areola areas; The third and the fifth intercostal nerve distributes to the nippleareola areas, but not constant.2、Clinical part：2.1According to The Breast-Q, the scores of patient’ s own evaluation on the breast,confidence, sex life, symptom were statistically significant differences comparing withpreoperative,. All the patients had high scores in satisfaction.2.235cases of micromastias,5cases were lost follow-up, To breast augmentationpatients, compared with preoperative, chest circumference over the nipple, the sternalnotch to nipple distance, areola diameter,, breast fitness score, were statisticallysignificant differences. there was no complications，such as hematoma, infection,prosthesis displacement. There was1case who suffered capsular contracture sixmonths later after operation, We changed the prosthesis for her, six months later,capsular contracture did not happen.2.316cases of breast hypertrophy,3cases were lost follow-up, who was respectivemild,medial and severe breast hypertrophy. There were statistically significantdifferences in the distance between suprasternal fossa and areola diameter，bustdifferences and breast fitness score. After breast reduction, breast are plump andstraight, no nipple necrosis, infection and other complications emerged. In verticaldouble-pedicle group, of which1case suffered skin necrosis at the triangular flap,healed by active treatment. After surgery, the somatic and psychological symptomsdue to breast hypertrophy relieved or disappeared. After remodeling the breast, most ofthe cases were very satisfactory with the result, nipple sensation decreased in varingdegrees in patients of the vertical bi-pedicle group. In double loop breast reduction，patients have a good feel in the nipple and areola. The shape of the breast are good andthere is less compliacations. Conclusion1. The breast blood supply consists of the intercostal perforating branches of internalthoracic artery, lateral thoracic artery and thoracic acromial artery and the verticalperforating branches of intercostal arteries. There are various vascular interconnectiontraffic branch between them. The lateral branches and the anterior branches of theT2-T6intercostal nerves innervate the breasts, The fourth intercostal nerve innervatesconstantly the nipple areola areas.2. The Breast-Q is a good quantitative indicator in the evaluation of breast plasticsurgical treatment. It can be used in the evaluation of patient’s subjective satisfaction,changes in quality of life, psychological and spiritual aspects。.3. Breasts are plump, soft, and rightness after breast augmentation. Breast augmen-tation with silicon Prosthesis is a good choice for micromastia.4. Double loop technique of breast reduction surgery, designing and operatingeasily, has less complications, the nipple and areola has no sensory impairments. It isan ideal surgery technique for mild and moderate breast hypertrophy.5.The vertical bi-pedicle breast reduction plastic surgery is easier to design, canremove more breast tissue. The breasts are plump and natural after surgery. It is a goodchoice for the severe hypertrophy to carry on the breast reduction.