Clinical Experience Of Reduction Mammaplasty With Mckissock's Procedure And Modification Of "Round Block" Technique

BackgroundMammary hypertrophy , also called macromastia is a terrible disease ,because of the hyperplasty of glandular tissue, fat and the connective tissue ,then the excess increased breast volume .It is a type of breast anisotrophy that can cause body symptoms, including shoulder pain, shoulder strap grooving, upper and lower back pain, the anabrotic skin even eczema in submammary fold.And patients always bent their back to hide the macromastia,so the angular curvature forming. Psychological issues are also associated with breast hypertrophy. Women often report embarrassment, bad social intercourse and low self-esteem.Breast reduction is the only way to cure the disease. Reduction mammaplasty is a Procedure that exsecting partial skin, fat and glandular tissue to reduce the volume and change the position of breast ,then remodeling by several methods.It can removal the body symptoms and terrible feeling.Mammaplasty was begined in the 17th century, at that time,people just cut and removed the glandular tissue to reduce volume .Its so rude ,and could not be called reduction mammaplasty.From the beginning of the 20th century , reductionmammaplasty began to be advancing.For gaining more and more clinical experience,plastic surgeons began to realize the importance of anatomy,and began to study the breast anatomy.People emphasized to protect the vascular support to the rest glandular. Papillary pedicle skin flap was widely used. Procedure became more refined, and payed more attention to protect the vascular and nerve.Preoperation design was important.In order to gain the symmetry of both breast, reserving the viability and sensibility of nipple-areolar, avoiding second ptosis and short scar,a lot modification techniques were reported,such as volume measurements, nipple-pedicle skin flap transposition, ways of glandular resection , mastopexy , incision design,etc.By the different approach and incision opening ,there are many procedures ,like Inverted T Scar Breast Reduction, Vertical Reduction Mammaplasty , periareolar mammaplasty , L scar Breast Reduction,etc.There are many types of nipple-aerolar pedicle,such as superior pedicle, inferior pedicle, lateral pedical, vertical pedical, double pedicle flap,etc. No technique is suited to all occasions and that all methods currently in use have various shortcomings.Tradition Mckissock technique, Vertical Reduction Mammaplasty (Lejour Vertical Mammaplasty) and periareolar mammaplasty, and their modification procedures . Objective: observe the indications , operative skills , the operative results and lone-term comparative effect of Mckissock' s Procedure and Modification of "Round Block" technique used in the mammaplasty.Method :Mckissock' s Procedure and Modification of "Round Block" technique were used in the mammaplasty on 10 patients aged 20-48 with macromaslia and mastoplosis respeclively. After operation ,the patients were followed up for 5-12 monthes.First,we gathered the clinical data s:preoperation symptoms measurements,incision design, technique, operation time, blood loss, excision measure , post-op shape, complications (haematoma, infection, disruption of wound, nipple-aerola necrosis, hyperplasy of scar, decreased sensation of nipple-aerola, relapse, ect) , post-op satisfaction.then analyzed and compared. Results:1, All patients gain the symmetry of both breasts.2, The incidence of complication of Mckissock's Procedure were more than Modification of "Round Block" technique.3, Patients undergoing Mckissock' s Procedure had more incidence of sensory disability and bad vascular support.4, Mckissock' s Procedure can removal more tissue than "Round Block" technique5, Patients reflect more satisfaction for Modification of "Round Block" technique.Conclution:The modified "round block"technique is an ideal breast reconduction method for mild and moderate macromastia .the most concerned factors related with result wre the figure of the breast and the sensation of the breast. The Mckissock' s Procedure is an ideal breast reconduction method for moderate and severe macromastia .