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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_884_Библиотеки_им_академика_М_И_Перельмана
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Fig. 7.44
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Fig. 7.45
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6. The nipple stalk is de-epithelialized (Fig. 7.46)
7. The medial and the lateral regions of the pillar as far as the pectoral
fascia is now incised using monopolar electrocoagulation (Fig. 7.47)
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Fig. 7.46
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Fig. 7.47
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8. During this procedure, care should be taken to ensure that no
distinctivesurfacesareformed,inparticularintheregionofthe
centrocaudal stalk (Fig. 7.48)
9. The assisting surgeon holds the breast with a retractor (Fig. 7.49)
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Fig. 7.48
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Fig. 7.49
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10. The lateral and medial tissue triangle is then resected. The resec-
tion material is weighed and subsequently analyzed histologically
(Fig. 7.50)
11. To improve breast shape, the medial and the lateral pillars are
individually undermined in the epifascial regions (Fig. 7.51)
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Fig. 7.50
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Fig. 7.51
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12. The inferior nipple stalk is moved in a cranial direction. Care
should be taken that there is at least 2 cm of tissue in the cranial
region of the NAC. However, no distinctive surfaces should be produced, as thiscan significantly impair blood supplyto the nipple
(Fig. 7.52)
13. Dissection of the cranial compartment for insertion of the stalk by
means of electrocoagulation (Fig. 7.53)
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Fig. 7.52
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Fig. 7.53
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14. The future breast shape is simulated by meansof ‘trial adaption:’
Trial fixation of the medial and lateral pillars with the base
(triangular suture) using 2.0 Monocryl. The vertical pillar is then
clamped into place (Fig. 7.54)
15. The new NAC position is now determined. The new NAC is marked
with the mammotome. (Fig. 7.55)
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