Izindlela, Izinzuzo Ne-Cons, kanye Nezingozi ze-Nipple ne-Areola Reconstruction
Kunezinqumo eziningi ezenziwa ngesikhathi somdlavuza webele nangemva. Kungase kubonakale njengokukhetha ukwakhiwa kabusha, futhi ukwakhiwa kakhulu kwe-nipple kanye nokwakhiwa kwe-areola kuncane kwi-totem pole, okungenani ngokuhlobene nemithi yomdlavuza wesifuba ongasindisa impilo yakho, kodwa lezi zindlela zokwelapha zindlela zokubuyisela impilo yakho. Kungenani, indlela yokuzizwa kahle ngangokunokwenzeka emva kokwelapha.
Sibutsetelo
Ukukhetha kokuqala ngokuvuselela kuqala ngokukhetha kwakho ukuhlinzwa; kungakhathaliseki ukuthi unayo i- lumpectomy noma i- mastectomy , kungakhathaliseki ukuthi usheshe noma ukubambezela kabusha, noma ungakhethi ukuvuselelwa nhlobo.
Kuye indawo yomdlavuza wakho, ungase ube ngumuntu obhekene ne-mastectomy ye-nipple-sparing-sparing. Le nqubo iyaba yinto evamile futhi ijwayele ukuba nezinga eliphezulu lokwaneliseka, nabesifazane abanalo ndlela yokubika ikhwalithi engcono yokuphila. Akuwona wonke odokotela abahlinzayo abawenzayo noma bakhululekile ngale ndlela, futhi kungadingeka ucabangele umbono wesibili esikhungweni somdlavuza omkhulu uma lokhu ufisa ukucabangela.
Uma ungenayo i-nipple yokugwema i-mastectomy, isinqumo sokugcina sihilela ukukhetha ukuba ne-nipple kanye nokuvuselelwa kwe-areola.
Ubuhle nobubi
Njengokukhetha okuningi okwenzile ngomdlavuza wakho webele, kunezinhlobo eziningi zezinzuzo nezindleko zokucabangela ekukhetheni ukuba ube ne-nipple kanye nokuvuselelwa kwe-areola.
Asikho isinqumo esilungile nesilungile okufanele senziwe, kuphela isinqumo esifanele wena ngokwakho.
Izinzuzo
Izinzuzo ze-nipple kanye nokuvuselelwa kwe-areola ngokuyinhloko ukuthi ukubukeka kwesifuba sakho kuseduze kakhulu nokubonakala ngaphambi kokuba uhlolwe umdlavuza webele.
I-Cons
Kukhona futhi ukungalungi kokuvuselelwa kwe-nipple. Lokhu kungafaka
- Iqiniso lokuthi lokhu kwakhiwa kabusha akuyona inqubo yokuhlinzwa eyodwa. Lokhu kubeka izingozi ze-anesthhesia jikelele, isikhathi esengeziwe sokutakula, futhi okungenzeka, izibazi ezengeziwe (esiteshini se-areola / ingono entsha, nasesiteleni somnikelo uma ukuhlanganiswa kusetshenziswa.)
- Ukwakhiwa kwengono kungase kwandise inqubo "yokuqhubeka nempilo yakho."
- A "con" engavamile ukukhulunywa, kodwa okuvamile, ukuthi abanye abesifazane bakuthola kungakhululekile ukuhamba braless emva ingono ingono kanye isola kunokuba bengenalo kabusha. Ekwakhelwe kabusha isifuba esenziwe kahle, abesifazane abaningi abajabuli ukugqoka ubhiya, futhi ukuvuselelwa kwezinsipho kungaphazamisa leyo nkululeko (noma bangase basebenzise ekusebenziseni ama-bandaids kanye ne-tepi ukumboza izingono zabo ezintsha.) Ngokungafani nama-nati "emvelo", avuselelwe izingono zinezikhundla ezilodwa futhi azibuyiseli. Abanye besifazane bayamahloni ngokuphakama okuqhubekayo kwesikhumba esakhiwe kabusha esingabangela ukuba babukeke "bevuswe," noma okungenani kubanda.
Isikhathi sokuhlinzeka
Ngokuvamile, ukwakha kabusha kwe-nipple kanye ne-areola kwenziwa cishe ezinyangeni ezintathu kuya kweziyisithupha ngemuva kokuqala kabusha.
Lokhu kuvumela ukuphulukiswa okulungile nokusabalalisa ukuvuvukala kwe-post-op. Noma kunjalo, isikhathi singahluka kakhulu ngokusekelwe odokotela abahlinzayo kanye nesiguli, kanye namasu athile asetshenziswa kuzo zombili izinqubo.
Izindlela zokuvuselela kabusha
Isinyathelo sokuqala ekwakhiweni kabusha kuhilela ukusebenzisa i-graft yesikhumba noma i-flap ukuze uvuselele isikhukhula se-ingono. Lokhu kulandelwa yi "tattooing" lapho isisindo esakhiwe kabusha siphululiwe. Ngezinye izikhathi, ukudweba imibala kuphela kuyasetshenziselwa ukudala ukubonakala komunwe kodwa ngaphandle kokuhlinzwa okuqhubekayo.
Ukulungiswa kabusha kweGraft
Inqubo yokuhlanganiswa yokwakhiwa kwe-ingono kanye ne-areola ihilela ukuvuna isikhumba esakhiweni somnikeli esihlukile kwesifuba esakhiwe kabusha.
I-graft yesikhumba ihanjiswe esakhiweni se-ingono esanda kwakhiwa kanye / noma i-areola.
Izingosi ezivame ukuxhaswa nge-areola grafts zihlanganisa ubuhlungu besisu esisuka ekwakhiweni kwe-flap, intamo yangaphakathi, noma i-buttock crease. Ukuze uthole ama-grappra ingxube, lezi zindawo ezintathu ezivame kakhulu ezixhaswa yizimbongolo ezisele isiguli, i-earlobe, ne-labia. Ngokuvamile, ingono yesiguli esele isayithi elixhasayo lomnikeli, ngoba linikeza umdlalo omuhle ngokukhanda kwesikhumba nombala. Kodwa-ke, uma kwenzeka i-mastectomy yamazwe amabili (noma ama-nipples amancane), amanye amasayithi anikezelayo angasiza kakhulu.
I-Flap Reconstruction
Esikhathini sendlela yokuvuvukala ekwakhiweni kwezingono, isilonda se-nipple sidalwe "esikhwameni" sesikhumba esithathwe ngokuqondile esikhumbeni esiseduze nesayithi le-ingono esanda kuvuselelwa. Le nqubo inenzuzo yokugcina igazi lihambelana kahle, nokuvimbela noma yikuphi ukulimala endaweni yengane entsha kanye ne-areola (ngokuphambene nokudala uhlamvu olusha kwisayithi lomnikeli, njengenqubo yokuhlanganiswa). Inqubo ye-flap isethembeke kakhulu kunenqubo yokuhlanganiswa.
Ukwakhiwa kabusha nge-micropigmentation (Tattooing)
Inqubo yokudweba umzimba, ebizwa ngokuthi i-micropigmentation, ivame ukuqhutshwa njengesigaba sokugcina sokuvuselelwa kwesifuba esiphelele, kuphela ngemva kokuba ingono ngokwayo ivuselelwe. Le nqubo yenziwa ngemishini efana kakhulu nalokho umuntu angase akuthole ekusetshenzisweni kwesitolo somdwebo. Inzuzo eyinhloko yukuthi kuyindlela ephuthumayo futhi elula yokuphulukisa izidakamizwa ezingadingi ukwedlula i-anesthesia yendawo, futhi ayidala uketshezi olwengeziwe. Empeleni, i-micropigmentation ingasetshenziswa ukufihla umbala ngisho nokunciphisa ukuthungwa kwezibazi ezikhona ngemuva kwenkambiso yokuqala yokuvuselelwa kwebele.
Ngokuyinhloko, le nqubo isetshenziselwa ukulingisa umbala, ukuma, nokuthungwa kwendawo ezungeze ingono (ebizwa ngokuthi i-areola). Kodwa-ke, kulabo abagulayo abafisa ukuhlinzwa ngokuqhubekayo ngemva kokuvuselelwa kwebele, kuqala ukubukeka kwesikhumba kungase kudalwe besebenzisa ukudweba umzimba. Ukulimala okusobala kwalendlela yukuthi kungenza kuphela ukukhanya okubonakalayo kokuthungwa nobude, kungabikho ukuhlolwa kwe-nipple, kodwa isifundo se-2016 sitholile ukuthi ukulahlekelwa kokubheka kwesikhumba akuzange kunciphise ukwaneliseka kwabesifazane abanobuchwepheshe. Lena futhi inqubo ephephile kakhulu.
Kwezinye izimo, udokotela wakho ohlinzayo angase ancoma ukusetshenziswa kwalawo majaji njenge-Radiesse noma i-Alloderm ukuze kuthuthukiswe ingqikithi yengono. Kulesi simo, kungase kube usizo ukubuka ngqo udokotela ohlinzayo noma ochwepheshe be-micropigmentation obhekene ngokukhethekile ekudaleni ukubukeka okungokoqobo nokubukeka kwezinto ezintathu.
Udokotela wakho ohlinzayo noma ochwepheshe uzoxuba izingulube ezihlukahlukene ukuze avele nombala ofanele ukusiza amathoni akho esikhumba kanye / noma ukufanisa ingono yakho esele. Ukufeza i-shades ephelele kungadinga ukuvakashelwa okungaphezu kweyodwa, futhi njenganoma iyiphi i-tattoo, i-pigment izophela ngokuhamba kwesikhathi, idinga ukuvakashelwa kokubuyela kumbala wokuthinta umbala.
Izingozi nezinkinga
Okokuqala, kunokwenzeka ukuthi ukuhlanganiswa noma i-flap kungenzeka ukuthi ingasinda endaweni yayo entsha. Uma lokhu kwenzeka, ukuhlinzwa okuqhubekayo kuyodingeka. Ngaphezu kwalokho, uma i-anesthesia ejwayelekile isadingeka, kunezingozi ezivamile ezihambisana nayo, kanye nezingozi nezinkinga ezingenzeka ezihambisana nezinqubo eziningi zokuhlinza, okufaka: ukulimala okungahambi kahle, ukuphuma ngokweqile noma i- hematoma , ukulahlekelwa isikhumba (ukufa kwezicubu) , i- blood clots , ama-clots amafutha, ukukhishwa kwesikhumba noma ukuguqulwa okungavamile, izingozi ze-anesthesia , i-edema eqhubekayo (ukuvuvukala), i-asymmetry, ukuguquka kwesikhumba, ubuhlungu obuqhubekayo, ukulimala ezakhiweni ezijulile ezinjengezinzwa, imithambo yegazi, imisipha, amaphaphu, kanye nezitho zangasese , i-thrombosis ejulile ye-vein, izinkinga ze-cardiac kanye ne-pulmonary, imiphumela engabonakali yokuhlola, kanye nesidingo sokuhlinzwa okungeziwe.
Kulabo abane-radiation therapy ngaphambi kokuvuselelwa, ingozi yemiphumela emibi (ingono ye-necrosis) iphakeme, futhi kubalulekile ukukhuluma nodokotela wakho ngokucophelela uma ucubungula noma ngabe une-radiation therapy.
Emva kokuhlinzwa, shayela udokotela wakho ohlinzayo ngokushesha uma kukhona okulandelayo okukwenzekayo: ubuhlungu besifuba, ukuphefumula, izinhliziyo ezingavamile, ukuphuma ngokweqile.
Izindleko
Ezimweni eziningi, ukuvuselelwa kwe-nipple kanye ne-areola kubhekwa njengesinyathelo sokugcina ekuvuselelweni kwesifuba se-post-mastectomy. Ngakho-ke, ngokomthetho, izindleko ziyobekwa ngumshuwalense wesifazane. Kodwa-ke, kufanele uhlole njalo umhlinzeki wakho womshuwalense mayelana nemininingwane yokufaka kwakho ngaphambi kokuhlela noma yikuphi ukuhlinzwa. Ezinye izinhlelo zomshuwalense ziqondisa ukuthi ungaya kuphi ukuhlinzwa kanye nezinhlobo ezithile zezinqubo ezihlanganisiwe.
Ukunakekelwa kwe-Post-Op
Ukulandela inqubo, ukugqoka okungekho okunamathelisi nokugcoba amafutha okugcoba kuyothathwa esifubeni sakho futhi kugcinwe endaweni nge-tape yokuhlinza. Ukugqoka kuzodinga ukushintshwa njalo amahora ambalwa ezinsukwini ezimbalwa zokuqala. Uma ubhalwe phansi njengengxenye yokwakhiwa kabusha kwakho, umdwebo wakho uzothuthukisa ingxube negazi. Kubalulekile ukungavumeli ukuthi tattoo ibe eyomile, noma ukuvumela ukungqubuzana ngokweqile phakathi kwezingubo kanye ne-tattoo ngalesi sikhathi.
Ngenxa yegazi, umbala we-tattoo uzobonakala ubumnyama kunokuba uzobe usuphilile. Phakathi nenkathi yokuphulukisa, isikhumba sizokwakha futhi siwe, sikhombise umbala weqiniso we-tattoo. Ungakhethi esikhaleni noma zama ukususa. Uma kususwe kusenesikhathi kakhulu, isikhumba sizothatha okuningi kwe-pigment tattooed nayo.
Ukubuyiselwa nokuphumula
Ukwakhiwa kabusha kwe-nipple kanye ne-areola ngokuvamile kuyinkqubo yokuphulukisa iziguli ezidinga ngaphansi kwehora ukuqedela. Iziguli eziningi zizobhekana nobuhlungu obuncane noma obuhlungu obungase buphathwe nababulali obuhlungu, futhi bazokwazi ukubuyela emisebenzini yabo evamile ezinsukwini ezimbalwa.
Njengazo zonke izinqubo zokuhlinza, kubalulekile ukuqonda ukuthi le mihlahlandlela ingahluka ngokubanzi ngokusekelwe empilweni yomuntu siqu yesiguli, amasu asetshenziswayo, nezinye izici eziguquguqukayo ezungeze ukuhlinzwa. Kungakhathaliseki ukuthi kubalulekile ukuthi uqaphele ukuthi ungahambisani nezindawo zenkambiso ekusebenzeni ngamandla, ukuphazamiseka noma ukunyakaza ngesikhathi sokuphulukisa. Noma yibuphi ubuhlungu obukhulu kufanele bubikwe kudokotela wakho.
Ukuthukuthela nokuzwela
Uma ukuvuselelwa kufezwa ukudweba imibala kuphela, akukho ukukhishwa okusha okudalwe. Endabeni yokwakhiwa kwe-flap, izibazi ezincane zivame ukuhlala ngaphakathi kwendawo ye-ingono futhi zivame ukufihla ukuvuselelwa kwe-areola. Uma kusetshenziswe inqubo yokufaka ama-graft, uhlamvu olusha luzovela nxazonke ze-areola entsha. Ukwaziswa okwedlule nakho kudalwe kwisayithi lomnikelo.
Kungakhathaliseki indlela esetshenziselwa ukwakha kabusha, kubalulekile ukuba ulungele ukuthi indawo entsha yesikhumba ngeke ibe nesisindo esifanayo nesikhumba sesifuba esisele (noma amabele angokwemvelo sangaphambilini).
Izwi elivela
Ukukhetha ukuthi ngabe ukuvuselelwa kwezinsipho noma cha kuphelele kuwe futhi akuyona indlela efanele noma engalungile. Uma unomuzwa wokuthi usuvele uhlinzwa ngokuhlinzwa, noma ungafuni ukukhathazeka ngezinye izindlela zokwelashwa (noma izingono ezingaphenduki) azizwa sengathi kufanele ulandele kulezi "zinyathelo zokugcina" zokuvuselela. Futhi uma ufuna ngempela ukwakha kabusha nabangani noma umndeni okwesibili ukuqagela wena, qhubeka futhi wenze okusebenza kahle kuwe wedwa.
Njengoba ucabanga ngohambo lwakho ngomdlavuza wesifu kanjalo kuze kube manje, ungase uzizwe ukhululekile futhi ukhathele. Kungase kube induduzo encane ukubona ukuthi umdlavuza ushintsha abantu ngezindlela ezinhle kahle . Ucwaningo olubheke "ekukhuleni okuqhubekayo" kubantu abanomdlavuza bathole ukuthi abasindile bomdlavuza abagcini nje ngokubonga kakhulu impilo kodwa bavame ukuba nesihawu kwabanye.
Imithombo:
Mota, B., Riera, R., Ricci, M., Barrett, J., de Castria, T., Atallah, A., noJ. Bevilacqua. I-Nipple- ne-Areola-Sparing Mastectomy ye-Treatment of Cancer Breast. I-Cochrane Database yezibuyekezo ezihleliwe . 2016. 11: CD008932.
Satteson, E., Brown, B., noMnuz Nahabedian. Ukwakhiwa kabusha kwe-Nipple-Areolar Complex nokugculiseka kwesineke: Ukubuyekezwa okuhlelekile kanye nokuhlaziywa kwe-Meta-Analysis. Ukuhlinzwa kwe-Gland . 2017. 6 (1): 4-13.
Sisti, A., Grimaldi, L., Tassinari, J. et al. Izindlela zokuvuselelwa kwe-Nipple-Areola Complex: Ukubuyekezwa Kwamabhuku. I-European Journal of Oncology Yokuhlinza . 2016. 42 (4): 441-65.