[fusion_builder_container background_color=”#f1f1f1″ background_image=”/wp-content/uploads/2015/03/drops-on-leaf-wallpaper-1024×640222.jpg” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ background_repeat=”no-repeat” background_position=”left top” video_url=”” video_aspect_ratio=”16:9″ video_webm=”” video_mp4=”” video_ogv=”” video_preview_image=”” overlay_color=”” overlay_opacity=”0.5″ video_mute=”yes” video_loop=”yes” fade=”no” border_size=”0px” border_color=”” border_style=”solid” padding_top=”20px” padding_bottom=”20px” padding_left=”0px” padding_right=”0px” hundred_percent=”no” equal_height_columns=”no” hide_on_mobile=”no” menu_anchor=”” class=”” id=”op-top-banner”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][fusion_text]

兩階段重建Two-stage Reconstruction

[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container][fusion_builder_container background_color=”” background_image=”” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ background_repeat=”no-repeat” background_position=”left top” video_url=”” video_aspect_ratio=”16:9″ video_webm=”” video_mp4=”” video_ogv=”” video_preview_image=”” overlay_color=”” overlay_opacity=”0.5″ video_mute=”yes” video_loop=”yes” fade=”no” border_size=”0px” border_color=”” border_style=”solid” padding_top=”20px” padding_bottom=”20px” padding_left=”0″ padding_right=”0″ hundred_percent=”no” equal_height_columns=”yes” hide_on_mobile=”no” menu_anchor=”” class=”” id=””][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][fusion_text]對於乳房已經做過次全切除或是全切除手術，或是曾經接受過放射治療（電療）的患者，因患側的皮膚條件較為單薄且緊縮，甚至出現了纖維化等反應，並不適合直接進行一階段的義乳植入，否則容易發生莢膜孿縮，義乳變形或甚至是傷口癒合不佳等併發症。為了確保乳房重建手術的安全與效果，此類患者應該接受兩階段的手術步驟：

第一階段鹽水擴張袋植入
針對患側的乳房進行暫時性的鹽水擴張袋植入。莊醫師首先會於原乳房的傷疤處切開一道約3~4cm的傷口，運用內視鏡與電燒刀進行皮下組織的空間撥離後，即會植入暫時性的鹽水擴張袋。此袋會於身體側邊埋入一個注水球，方便日後定期灌注食鹽水，以漸進的方式擴充皮膚的張力與彈性，也為日後的義乳植入擴充較大的空間。目前莊醫師採用的是新式的切口與快速擴張方式，一般於手術當下即能灌注50~70%的擴張袋水量。此法不僅可以快速擴張乳房皮下空間，有效縮短重建等待期，且患者只須每個月回診一次灌注鹽水，無須如傳統手術般須頻繁的往返醫院進行注水，徒增患者的不適與感染等風險。以此方式平均約三個月後即能進行第二階段的義乳植入手術。
第二階段果凍矽膠義乳植入
組織擴張袋經過3~4個月的鹽水灌注後，已經將乳房的皮膚與內部空間擴充到足以安全植入義乳的標準，此時即能著手進行第二階段的永久性義乳植入手術。手術的進行會先將患側的鹽水擴張袋取出，運用電燒刀與內視鏡將既有的空間做再次的撥離後，即能植入符合空間大小的果凍矽膠義乳，許多追求完美的患者也會擇同時接受對側（正常側）乳房的內視鏡隆乳手術，以達到更為對稱與均衡的效果。

此兩階段手術的優點是避免單一階段重建的手術風險，例如：莢膜孿縮、義乳移位或變形，與傷口癒合等不確定性，且乳房皮膚經過一段時間的擴張後會趨於穩定不易緊縮，有助於術後乳房按摩與效果的維持，另外患者也能爭取較多的時間考慮自身須求，不受皮膚張力的限制來選擇各種義乳的樣式與尺寸，手術的客製化程度較高。而其缺點則是重建時間較為漫長，在擴張期間可能因皮膚壓力過大導致傷口癒合或發炎感染等問題，且單邊植入擴張袋常影響患者的穿衣便利性。

此手術不僅適用於因乳癌而做過乳乳房切除與放射治療的患者，針對胸部曾注射過大量液態矽膠導致多發性硬塊或乳房變形的患者，莊醫師也建議先做第一階段的矽膠與乳腺切除手術合併鹽水擴張袋植入，待注水3~6個月後再做第二階段的義乳植入重建手術，以確保手術的安全與效果。[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container][fusion_builder_container hundred_percent=”yes” overflow=”visible” margin_top=”20px” margin_bottom=”20px” background_color=”rgba(255,255,255,0)”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][fusion_separator style_type=”none” sep_color=”” border_size=”” icon=”” icon_circle=”” icon_circle_color=”” width=”” alignment=”center” class=”” id=””/][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container][fusion_builder_container background_color=”” background_image=”” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ background_repeat=”no-repeat” background_position=”left top” video_url=”” video_aspect_ratio=”16:9″ video_webm=”” video_mp4=”” video_ogv=”” video_preview_image=”” overlay_color=”” overlay_opacity=”0.5″ video_mute=”yes” video_loop=”yes” fade=”no” border_size=”0px” border_color=”” border_style=”solid” padding_top=”20px” padding_bottom=”20px” padding_left=”0″ padding_right=”0″ hundred_percent=”no” equal_height_columns=”no” hide_on_mobile=”no” menu_anchor=”” class=”” id=””][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][fusion_imageframe lightbox=”no” gallery_id=”” lightbox_image=”” style_type=”none” hover_type=”none” bordercolor=”” bordersize=”0px” borderradius=”0″ stylecolor=”” align=”center” link=”” linktarget=”_self” animation_type=”0″ animation_direction=”down” animation_speed=”0.1″ animation_offset=”” hide_on_mobile=”no” class=”” id=””] 乳房重建-兩階段重建示意圖 [/fusion_imageframe][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container][fusion_builder_container hundred_percent=”yes” overflow=”visible” margin_top=”20px” margin_bottom=”20px” background_color=”rgba(255,255,255,0)”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][fusion_separator style_type=”none” sep_color=”” border_size=”” icon=”” icon_circle=”” icon_circle_color=”” width=”” alignment=”center” class=”” id=””/][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container][fusion_builder_container background_color=”” background_image=”” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ background_repeat=”no-repeat” background_position=”left top” video_url=”” video_aspect_ratio=”16:9″ video_webm=”” video_mp4=”” video_ogv=”” video_preview_image=”” overlay_color=”” overlay_opacity=”0.5″ video_mute=”yes” video_loop=”yes” fade=”no” border_size=”0px” border_color=”” border_style=”solid” padding_top=”0″ padding_bottom=”0″ padding_left=”0″ padding_right=”0″ hundred_percent=”yes” equal_height_columns=”yes” hide_on_mobile=”no” menu_anchor=”” class=”” id=”op-content”][fusion_builder_row][fusion_builder_column type=”1_3″ last=”no” spacing=”no” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” hover_type=”none” link=”” border_position=”all” border_size=”0px” border_color=”” border_style=”solid” padding=”0″ margin_top=”” margin_bottom=”” animation_type=”0″ animation_direction=”down” animation_speed=”0.1″ animation_offset=”” class=”” id=”bd-right”][fusion_text]

手術內容

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第一階段手術時間

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麻醉方式：全身麻醉
手術切口：原乳房切除傷口處
恢復期：2~3天內
拆線：7~10天

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手術內容

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第二階段手術時間

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麻醉方式：全身麻醉
手術切口：原乳房切除傷口處（重建側）乳暈或腋下（隆乳側）
恢復期：3~5天內
拆線：7~10天

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注意須知

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手術前需禁食與水

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第一階段擴張袋植入後須避免按摩與重壓胸部
第二階段重建完成後乳房按摩至少須持續6個月
術後一個月內需避免手臂過度使力或運動
術後三個月內禁止穿著硬鋼絲或集中型胸罩

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適應對象

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乳房經全切除或次全切除的患者
乳房切除後接受過放射治療的患者
因大量矽膠注射導致硬塊須做乳腺切除者
前胸皮膚因嚴重燒傷而導致疤痕孿縮者
前胸皮膚厚度少於1cm者

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可能併發症

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擴張袋滲漏
感染
傷口癒合不良
莢膜孿縮
義乳移位
義乳波紋或皺褶
前胸麻木感

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手術優點

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分階段進行手術，確保乳房重建的安全與效果
以鹽水灌注方式逐漸擴充乳房皮膚，有利大尺寸義乳的植入
乳房皮膚因擴張後趨於穩定，減少日後莢膜孿縮或義乳移位機率
術後按摩容易維護，乳房觸感較為柔軟
可合併進行對側隆乳手術，提升乳房的對稱性
患者可自由選擇光滑面或絨毛面義乳進行第二階段重建，客製化彈性較高

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手術缺點

兩階段重建過程較為漫長
患者須每月進行鹽水灌注，可能發生漏水或感染等疑慮
單側乳房擴張期間會產生暫時性的衣著困擾
手術花費較高

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可合併手術

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自體脂肪填補

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手術成果

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