역자서문

유방성형에 대해 우리나라를 비롯한 아시아권에서는 겨드랑이절개법을 적용하는 경우가 많은 반면, 대부분의 책에서 언급되고 논의되는 내용들이 주로 유방밑선절개를 이용한 방법이 상대적으로 많이 사용되고 있습니다. 유럽과 북미 남미 지역에서는 많은 의사들이 유방밑선절개를 주로 사용하고 있는 관계로 책이나 논문에 발표되는 내용들에서 겨드랑이절개법을 적용한 방법을 자세히 기술한 책이나 논문이 부족하고 이에 대한 배움의 기회도 적었습니다. 겨드랑이절개를 이용한 유방확대술의 경우 초기에 사용되던 blunt dissection을 이용하는 방법은 fine dissection이 되지 않기 때문에 수술의 과정이나 결과가 부족한 점이 많은 방법이었습니다. 내시경이 겨드랑이절개를 이용한 유방확대술에 적용되면서 direct vision 아래 fine dissection을 할 수 있는 새로운 바탕이 마련되었으나, 겨드랑이절개법을 이용한 내시경유방확대술에 대한 책이나 논문이 많지 않아 배움의 기회가 적었던 아쉬움이 있었습니다. 저자는 지난 10여 년 동안 내시경유방확대술 방법에 관한 경험을 토대로 내시경유방확대술에 필요한 해부학적 지식과 내시경장비에 관한 내용, 유방확대 계획에 관한 설명, 내시경을 이용한 겨드랑이접근 유방확대술의 술기 및 합병증에 관한 해결방법 등에 대하여 실제 술기를 중심으로 기술하려고 노력하였습니다. 유방성형술의 발전에 노력하시는 여러 선생님들께 본 저서가 작은 도움이 되고자 합니다.

CHAPTER 01 History of Augmentation Mammoplasty······················· 1

CHAPTER 02 Anatomy for Augmentation Mammoplasty ·················· 7

2.1 유방의 위치… ………………………………………………………………………… 8

2.2 모양과 구조… ………………………………………………………………………… 8

2.3 실질하방과 실질의 연장……………………………………………………………… 9

2.4 혈관분포………………………………………………………………………………… 9

2.5 신경분포………………………………………………………………………………… 14

2.6 림프관…………………………………………………………………………………… 16

2.7 근육……………………………………………………………………………………… 16

(1) 대흉근(pectoralis major muscle)… ………………………………………… 16

(2) 소흉근(pectoralis minor muscle)… ………………………………………… 19

(3) serratus anterior muscle……………………………………………………… 20

(4) external oblique abdominal muscle… …………………………………… 21

2.8 Fascia of anterior thoracic wall………………………………………………… 22

CHAPTER 03 보형물············································································ 25

3.1 실리콘보형물과 식염수보형물… …………………………………………………… 26

3.2 Smooth 보형물과 texture 보형물… ……………………………………………… 27

3.3 Round 보형물과 anatomical 보형물… ………………………………………… 28

CHAPTER 04 내시경 및 기구································································· 33

CHAPTER 05 수술 전 디자인································································· 37

CHAPTER 06 Transaxillary Endoscopic Augmentation Mammoplasty·························· 47

6.1 수술 전 준비…………………………………………………………………………… 48

6.2 수술과정………………………………………………………………………………… 49

6.3 Post op care… ……………………………………………………………………… 57

CHAPTER 07 Trnasaxillary Endoscopic Approach for

Dual Plane II &; III·························································· 67

7.1 수술 디자인… ………………………………………………………………………… 69

7.2 수술방법………………………………………………………………………………… 69

CHAPTER 08 Complications and Revisional Augmentation

Mammoplasty······························································ 79

8.1 Complications… …………………………………………………………………… 79

8.2 Revisional augmentation mammaplasty… ………………………………… 82

(1) Same pocket……………………………………………………………………83

1. Capsulotomy·················································································· 83

2. Partial capsulectomy···································································83

3. Capsulorrhaphy with abrasion·····················································84

4. Capsule coagulation for wide capsule shrinkage························84

(2) Pocket change………………………………………………………………… 85

1. Same location with total capsulectomy········································85

2. Subglandular to submuscular conversion····································85

3. Conversion to dual plane·····························································85

4. Submuscular to subglandular conversion····································86

5. Submuscular to supracapsular submuscular neospace··············86

찾아보기 99