Reconstrução do complexo aréolo papilar
técnicas para atingir um resultado satisfatório
Palavras-chave:
Mamilo, mamoplastia, aloenxertos, tatuagemResumo
A reconstrução do complexo aréolo-papilar (CAP) é o toque final da cirurgia de reconstrução mamária sendo parte importante na satisfação e saúde psicológica da paciente. Existem várias técnicas descritas, porém o maior desafio é a manutenção da projeção do mamilo ao longo do tempo. As técnicas mais utilizadas são as que utilizam enxertos locais com posterior tatuagem. Entretanto, é importante a individualização do tratamento, a técnica escolhida deve levar em consideração as características da paciente e da mama reconstruída para que o resultado final seja satisfatório. O presente artigo descreve método de planejamento, técnicas de reconstrução da aréola e do mamilo utilizando enxertos de retalho local, autólogo ou do mamilo contralateral e tatuagem.
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Referências
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Copyright (c) 2018 Priscilla Sodré, Juan Sebastian Sanches Tobar, Roberto Vieira, Carlos Ricardo Chagas

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.