Patent RU-2751929-C1 (RU)
Title: Breast reconstruction method
Inventor: Fedosov Semen Igorevich
IPC: A61B17/00
Filed: 2020-12-30
Granted: 2021-07-20
Abstract: FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to plastic surgery, reconstructive surgery, oncology. A monoblock musculo-dermal expander pocket is formed in case of delayed reconstruction or a musculo-glandular expander pocket in case of correction of tubular deformity of the breasts. A tissue expander with a built-in port is placed submuscularly. The tissue expander is filled with sterile saline through the built-in port weekly for one month. One month after the installation of the tissue expander at the preoperative stage, the recipient zone of the restored breast and donor zones are marked. During the operation, 50% of the tissue expander volume is evacuated through the built-in port, tumescent infiltration of donor zones is performed, exposure is performed, lipoaspirate is taken in an amount equal to three volumes of the reduced part of the tissue expander, the resulting lipoasprate is centrifuged. Subdermal, intramuscular and paracapsular transplantation of the treated adipose tissue is performed in the amount of one and a half volumes of the reduced part of the tissue expander. Three months later, at the preoperative stage, the recipient zone of the restored breast and donor zones are marked. Marking of the percutaneous circular blocking return suture is performed relative to the healthy breast in the case of delayed reconstruction and relative to the true spot of breasts in the case of correction of tubular deformity. During the operation, the tissue expander of the reconstructed breast is removed. Tumescent infiltration of donor areas is performed. Lipoaspirate is taken in the amount of three volumes of the removed tissue expander. The obtained lipoaspirate is centrifuged, subdermal, intramuscular and paracapsular transplantation of the treated adipose tissue is performed in the amount of one and a half volumes of the removed tissue expander. In this case, the tissue expander capsule acts as the main matrix for the transplanted adipose tissue. Two-plane liposuction of the skin of the lower one third of the chest on the side of reconstruction is performed, using a suture needle, two percutaneous circular recurrent blocking sutures are applied, the suture material is carried out subcutaneously parasternally on a segment from the subclavian region to the medial border of the submammary sulcus, in the projection of the marked submammary sulcus, continue intramuscularly on the segment from the lateral border of the submammary groove to the subclavian region is carried out deeply subcutaneously along the mid-axillary line. On a segment from the subclavian region to the axillary region, the suture material is passed subcutaneously and under the lateral edge of the pectoralis major muscle, creating a subdermal and submuscular recurrent component. In this case, the periosteum of the sternum and the lateral edge of the pectoralis major muscle act as the fixation points of the percutaneous circular recurrent blocking suture. Further, in the cranial direction, traction of the soft tissues of the lower slope of the reconstructed breast is performed, thereby forming the submammary groove, the external and internal contours of the breast, and the degree of ptosis and the clarity of the topographic landmarks of the reconstructed breast are regulated by the tightening force of the circular blocking suture, the operation ends with layer-by-layer wound closure.EFFECT: allows increasing the recipient capacity of the restored breast, as well as restoring all its topographic landmarks (inner contour, submammary sulcus, outer contour).1 cl, 17 dwg, 2 ex