縮提乳手術 由院長客製化設計，找回妳最自在的模樣 『胸部太大且下垂怎麼辦? 如何讓胸部變小或縮小?』是不少胸前過大女性的困擾與疑問，卻很少人為她們解答。特別是在華人文化中，想諮詢醫師處理卻又不好意思求診，也因此許多女性同胞們， 將此問題隱忍在心中，努力用緊身衣或小一號的胸罩讓胸部看起來小一點，長久下來，讓自己非常的不舒服。 為面臨此問題女性朋友，提供為個人量身打造的處理方式。下表為各種縮乳方式比較： 縮胸手術切口分三大類 倒T切口：適合皮膚極度鬆弛的縮乳手術，特別是大量減重後的下垂。 垂直切口：適合用在大多數的縮乳與提乳手術。 乳暈旁切口：只適合稍微的提乳與少量縮乳手術。 倒T切口縮乳手術 『倒T切口』此方法首先在乳暈下開一個類似『愛迪達』標誌的切口，並將多餘的乳房組織切除，最後將乳頭-乳暈提高，並將傷口縫合成「倒T字型」；優點是塑形容易，醫師操作易上手，缺點是留下一條橫向長的乳腺下疤痕且手術後的胸形會變平較寬；「此項手術特別適合用在：1. 乳房皮膚因過度拉扯造成彈性極度鬆弛者；2. 巨乳症而單側需切除2公斤以上者」。 垂直短切口的縮乳手術 垂直短切口的手術過程與調整相對於倒T切口縮胸手術來說較為複雜，但因傷疤只有乳暈至乳下線垂直一條，是令許多患者較滿意的手術方式；此方法首先要定位新的乳頭位置，並以此新乳頭的位置，畫一個類似「雪人Snowman」或「棒棒糖Lollipop」的記號，沿此記號將多餘的乳房組織切除，最後將乳頭-乳暈提高，並將傷口縫合成一條直線；優點是疤痕較短，手術完的胸型較挺，缺點是手術時需要較多調整的時間，術後胸型自然，柔軟且疤痕並不明顯，下圖為手術前後胸型變化示意圖。 (環)乳暈切口縮胸手術 此手術方式將胸部上提與縮小的效果非常有限，只適合用胸部不會過大且只有輕微下垂的案例，但術後常見的問題則是做出的胸部形狀極不自然，且乳暈旁的疤痕因張力太大，常導致術後乳暈變大，長期的結果通常不太好看，因此不太建議。 縮胸縮乳手術可能的副作用 感染(1%)，血腫(1%)，乳頭循環不良(0.05~0.1%)等 手術成果 縮乳手術 (1) 縮乳手術 (2) 縮乳手術 (3) 縮乳手術 (4) 回到乳房重建中心

最新消息 相關補助申請看這邊！ 2022 乳房重建補助申請，開始申請了! 10月乳癌防治月，關心女性朋友，本會秉持著幫助乳癌病友恢復身體心像完整。長年推動『乳房重建補助活動』，特別感謝「華電聯網股份有限公司」-陳國章董事長的愛心公益贊助，讓這份愛心可以延續下去。 NEW! 2022年乳房重建補助申請通過名單 2022年乳房重建醫療補助辦法 2022年乳房重建醫療補助申請書 2022年乳房重建協會入會申請書 回到乳房重建中心

ABSTRACT SUBMITTED Call for Abstracts We are pleased to invite you to submit abstracts for the 10th World Symposium of Lymphedema Surgery. The deadline to submit an abstract for consideration has been extended to January 31, 2024. You will be notified of your acceptance by February 15, 2024. Accepted Abstracts will be in the following three categories: oral presentations, video presentations, and poster presentations. Accepted abstracts will have a chance to be selected and published in a supplement to the Journal of Surgical Oncology. Abstract Submission Guidelines All abstracts are selected via peer review. The number of free papers which will be accepted is strictly based on the planned congress timetable and the evaluation results of referees. Abstracts must be written and presented in English. Grammar, spelling, and punctuation should be reviewed before submission. No proofreading will be done by WSLS. Abstract submission must be completed online via the Abstract Submission form on this website. Click the icon below to submit the abstract. For the withdrawal of a submitted abstract, please promptly notify us at 2024wsls@gmail.com , stating the title and author. Withdrawals are still accepted even after the submission deadline. For standardization, the acceptable length of the abstract should not be longer than 300 words. Time New Roman size 12 is recommended. If you require further assistance, please contact us at 2024wsls@gmail.com .

對稱性調整 找回自信、健康與美麗！ 乳房重建手術的主要目的是最終恢復對稱性和重建乳房之間的整體美感平衡，大多數婦女自然的乳房不是完全對稱的，然而重建乳房希望達到兩側大小及對稱性接近，病患的滿意度也會隨之增加並維持身體心像完整。 大變小，小變大-窈窕曲線再現 做乳房重建手術時健側乳房可同時做調整，對側乳房太小可同時做隆乳，對側乳房假性下垂可做提乳手術，而對側乳房若太豐滿或下垂可做縮乳手術。 對側乳房同時做調整手術，可增加病人對整體乳房重建的滿意程度。 國際水準-獨門祕訣 乳房重建團隊更於三年前首創獨步全球技術，將腹部三分之二皮瓣用於乳房重建側，三分之一腹部皮瓣用於健側隆乳手術，以自體皮瓣隆乳，改善病人對於義乳異物感的不適及疑慮，這項創新手術已發表在並已發表於2011年12月國際整形外科權威期刊「Plastic Reconstructive Surgery（整形與重建手術）」，主題為『Simultaneous scarless contralateral breast augmentation during unilateral breast reconstruction using bilateral differentially split DIEP flaps』，此篇論文同時榮登期刊封面。 右側波蘭氏症候群01 右側波蘭氏症候群02

瞭解更多有關淋巴水腫的成因，淋巴液和淋巴結的差別，淋巴系統的重要性，淋巴循環的流程圖，作為免疫系統的一部分，這些是你必須知道的事。 What is the Lymphatic System? As part of the immune system, the lymphatic system helps the body activate a specific immune response against viruses and bacteria. It retains fluid homeostasis in all different compartments of the body. It is made by channels called lymphatic vessels. These collect lymph from all over the body and deliver lymph to the regional lymph nodes or thoracic ducts and then back to the cardiovascular system. 淋巴水腫的原因是什麼？ 淋巴水腫的主要原因是淋巴系統無法正常排除淋巴液，導致液體堆積，讓手腳或其他部位腫脹。 它可以分為 先天性（原發性） 和 後天性（繼發性） 兩種。 先天性淋巴水腫：因為淋巴系統天生發育不全或功能異常，導致淋巴液無法順利流動。這種情況比較少見。 後天性淋巴水腫：比較常見，通常是因為某些疾病或治療影響了淋巴系統，例如： 癌症治療或放射治療。 當淋巴系統受損或堵塞時，淋巴液無法順利排出，就會在手臂、腿部或其他部位堆積，形成腫脹，這就是淋巴水腫。 What is Lymph fluid? Lymph is a colorless protein-rich fluid that physiologically collects waste products and pathogens. It is present in tissue and transported through the lymphatic system to regional lymph-nodes. The venous flow carries 90% of arterial blood back to the heart and the remaining 10% becomes lymph fluid in the interstitial. Peripheral lymph nodes drain approximately 4-8 liters of lymph fluid per day. The lymphocytes (infection-fighting cells) that reside in the lymph nodes activate a specific immune response against infection. What are Lymph Nodes? Lymph nodes are bean-shaped organs of the lymphatic system that are distributed widely throughout the body. They are composed by lymphoid tissue enclosed by a capsule of connective tissue. Lymph nodes are major sites of B cells, T cells, and other immune cells. They serve as filters for the blood and provide specialized tissues where foreign antigens and cancer cells can be trapped and exposed to cells of the immune system for destruction. They are typically found concentrated near junctions of the major lymphatic vessels and most prominently found in the neck, groin, and armpits. Why is the lymphatic system important? The lymphatic system has two important roles: activating the immune response against antigens and transporting lymph fluid. Both functions are important to preserve body homeostasis. When the lymphatic system is compromised by cancer, infections, surgery, trauma, or congenital issues, the affected part of the body is prone to swelling (lymphedema) and recurrent infection due to the faulty surveillance mechanism. The functions of the lymphatic circulation include prevention and resolution of edema, maintenance of interstitial fluid homeostasis, immune trafficking (the regulated transit of antigen-presenting cells to the lymphoid organs), and lipid absorption from the gastrointestinal tract. Recipient Site of Vascularized Lymph Notes Transfer I.Wrist, dorsal or volar II. Elbow III. Axilla IV. Groin V. Posterior proximal leg VI. Ankle, anterior or medial Pathophysiology of Lymphedema i. Lymph accumulation ii. Inflamation iii. Infection iv. Fat proliferation v. Fibrosis Donor Vascularized Lymph Notes 1. Submental 2. Supraclavicular 3. Thoracic 4. Groin 5. Omentum 6. Mesenteric 此圖右側肢體正常，左側為上肢及下肢淋巴水腫。 可使用的治療方法如：淋巴管靜脈吻合術或顯微淋巴結皮瓣移植。 Lymphatic Circulation Flowchart Explanation of Physiological and Non-Physiological Surgical Approaches for Treating the Lymphatic System 鄭教授淋巴水腫顯微外科手術學術里程碑 English

瞭解更多鄭明輝院長首創的淋巴水腫分級評分系統，透過客觀測量和先進的影像技術來分析症狀，能夠精準盤段及確保術後最好的結果。 Cheng Lymphedema Grading Systems Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery Lymphedema Grading Systems Using physical exam findings, history of disease and imaging modalities, several classification schemes have been proposed to stage lymphedema. Perhaps the most widely used is the International Society of Lymphology staging system. But this staging system is based only the clinical symptoms, but no objective measurement or imaging assessment. As our understanding of lymphedema has evolved and technologies improved, other staging systems based on clinical presentation, circumferential measurements, objective measurements, lymphatic imaging or a combination thereof have been proposed. Effective and precise treatment A system adopted by the world At our center, we use the Cheng Lymphedema Grading system based on symptom severity, circumferential difference, and lymphoscintigraphy imaging to determine appropriate treatment, which was published on the Annals of Surgical Oncology, a renowned journal: A Prospective Evaluation of Lymphedema-Specific Quality-of-Life Outcomes Following Vascularized Lymph Node Transfer. (Patel KM, Lin CY, Cheng MH.) and book: Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015. Cheng Lymphedema Grading Chinese English 上肢淋巴水腫分期（病例） Chinese English 資料來源： Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015, page 204. 下肢淋巴水腫分期（病例） Chinese English 資料來源： Principles and Practice of Lymphedema Surgery. Cheng MH, Chang DW, Patel KM (Editors). Elsevier Inc, Oxford, United Kingdom. ISBN: 978-0-323-29897-1. July 2015, page 204. Novel Taiwan Lymphoscintigraphy Staging System Dr. Cheng is the author of the Cheng Lymphedema Grading System with integration of Taiwan Lymphoscintigraphy Staging which was published in Annals of Surgery (the top Surgery Journal) in July 2018. The Cheng Lymphedema Grading System with integration of Taiwan Lymphoscintigraphy Staging, a comprehensive objective assessment tool that analyzes lymphedema symptoms with quantitative measurements and advanced imaging technology, can effectively help physicians evaluate the severity of lymphatic obstructions, determine the accurate diagnosis, select the most appropriate procedures to treat lymphedema, and ultimately ensure the favorable functional outcome and finest quality of life for lymphedema patients. Taiwan Lymphoscintigraphy Staging Chinese English 資料來源： Cheng MH, Pappalardo M, Lin C, Kuo CF, Lin CY, Chung KC. Validity of the Novel Taiwan Lymphoscintigraphy Staging and Correlation of Cheng LymphedemaGrading for Unilateral Extremity Lymphedema. Ann Surg. 2018 Sep;268(3):513-525 Partial obstruction Total obstruction Recommended reading journal A Prospective Evaluation of Lymphedema-Specific Quality-of-Life Outcomes Following Vascularized Lymph Node Transfer. Patel KM, Lin CY, Cheng MH. Ann Surg Oncol. 2015 Jul;22(7):2424-30 https://www.ncbi.nlm.nih.gov/pubmed/25515196 Validity of the Novel Taiwan Lymphoscintigraphy Staging and Correlation of Cheng LymphedemaGrading for Unilateral Extremity Lymphedema. Cheng MH, Pappalardo M, Lin C, Kuo CF, Lin CY, Chung KC. Ann Surg. 2018 Sep;268(3):513-525. https://www.ncbi.nlm.nih.gov/pubmed/30004927

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了解更多有關術後照顧的重點，患者不再需要穿戴壓力袖套、襪，但建議患者在術後接受3~6個月的復健，需要積極治療。 Post-Operative Care Say Goodbye to Compression Garments after Dr. Cheng's Lymphedema Microsurgery Post-Operative Rehabilitation The A+ Surgery Clinic provides comprehensive and extensive medical services before and after surgery. It is recommended that lymphedema patients receive post-operative rehabilitation for a period of 3- 6 months. It is most noteworthy that patients no longer need to wear compression garments after Dr. Cheng’s Side-to-End Lymphovenous anastomosis and vascularized submental lymph node flap transfer to distal recipient site for post-operative rehabilitation. It is recommended to massage from the proximal limb to the distal site for 15 minutes 3 times a day one month post-operatively for 3 to 6 months to further improve lymphatic drainage. Post-Operative Follow-Up The lymphedema of both upper and lower extremities can cause pain, discomfort, fibrosis, cosmetic problems, and mobility restraints for patients. It is common that lymphedema patients develop various degrees of depression due to physical discomfort, disfiguration, and emotional distress. With an average of a 2-year follow up after undergoing microsurgical microsurgery including Side-to-End Lymphovenous anastomosis and vascularized lymph node flap transfer to distal recipient site, the affected limb become softer overtime. 90% of lymphedema patients have seen size improvement with a mean circumferential difference of 50%. With the physical improvement, patients are subjectively pleased to resume daily activities and life styles they used to have. After vascularized submental lymph node flap transfer, you are asked to comply with the rehabilitation program, which includes progressive lower limb muscle strength training and reverse manual proximal (groin) to distal (ankle) lymphatic drainage. You are encouraged to gradually massage the flap, scar, and control body weight control starting after discharge. Reverse manual lymph drainage and flap massage are performed for 15 minutes/time, 3 times daily. You are advised to return to normal activity gradually as tolerated, and all other physiotherapy and compression wrapping are discontinued. Vascularized submental lymph node flap is placed on the wrist in accordance with the “pump” mechanism and effects of gravity. You do not need to wear a compression garment or bandaging after surgery but are allowed to wear a wrist brace or wrist support to hide the scar on the wrist after the wound complete healed. Another revision surgery to remove the skin paddle and superficial fat of the transferred flap to improve the cosmetic appearance and simultaneous liposuction of the thigh to decrease the production of lymph is recommended after 1 year of vascularized submental lymph node flap transfer. 1. Reverse manual lymph drainage: Time: Performed for 15 minutes/time, 3 times a day, from groin to flap. Method: Medium strength massage that compresses the skin, subcutaneous, fat and muscle in proximal (groin) to distal (flap) direction. This helps encourage drainage of the lymph drainage through the lymph flap and appropriate channels. 2. Flap massage: For increasing the venous drainage of lymph node flap pumping Time: Performed for 15 minutes/time, each 3 times daily. Method: Medium strength massage to pump lymph node flap and the scar around flap. 3. Body weight control: Time: Check body weight every day. Lighten your weight if your Body Mass Index(BMI) over 25. 4. Infection/cellulitis prevention and control: Most healthcare-associated infections are preventable through good hand hygiene. It’s important to identify and treat cellulitis early because the condition can spread rapidly throughout your body. Red area or “New red spots” of skin that tends to extend from distal to proximal Swelling Tenderness Pain Fever over 38.5℃ After the initial postoperative period, you are seen on a monthly basis by sending images. You may use any communication apps, such as Line, WhatsApp, Skype, e-mail or WhatsApp. Surgical outcomes are evaluated by your subjective improvement, circumferential measurements, the frequency of cellulitis, and via patient reported health-related quality of life outcome metrics. We will arrange ultrasonography, CT, and lymphoscintigraphy for checking the number of the lymph node on the flap, lymph node function and volume of the arm after one year.

為維護良好的醫療品質與看診舒適，本院採預約制，您可先以電話、 電子郵件、LINE或填寫線上表單等方式預約，我們會盡快與您聯繫！ Let's Connect Contact us To ensure high-quality medical care and a comfortable consultation experience, our clinic operates on an appointment-only basis. You can schedule an appointment via phone, email, LINE, or by filling out the online form. We will contact you as soon as possible! Business Hours: Monday to Friday, 8:00 AM to 6:00 PM. Closed on weekends. Address 3rd Floor, No. 337, Fuxing North Road, Songshan District, Taipei City (MRT Zhongshan Junior High School Station) Map Phone (+886) 02-2712-3373 Phone (+886) 0966-523-737 Phone Email aplussurgery@gmail.com Social Media LINE Name Gender * Male Female Other Email Region * Taiwan Others Phone Convenient contact time 選擇一個時段 Remark Send Appointment successful ！

眼型美學療程 Eye shape aesthetic treatment 去眼袋明眸術：跟NG泡泡眼、下眼袋一起說掰掰~~ 卸除下眼袋、填平淚溝、消除黑眼圈、撫平眼下細紋，一次解決眼周全部問題！ 眼型美學療程 Eye shape aesthetic treatment 去眼袋明眸術：跟NG泡泡眼、下眼袋一起說掰掰~~ 卸除下眼袋、填平淚溝、消除黑眼圈、撫平眼下細紋， 一次解決眼周全部問題！ 眼袋是怎麼形成的？會自然消失嗎？ 我們的眼睛下方通常會有脂肪保護緩衝，而脂肪前還會有「眼眶隔膜」的筋膜及「眼輪匝肌」的肌肉構造，提供眼睛完整的保護力，正常情況下不會有眼袋問題。然而，當脂肪堆積太多、下眼瞼肌膚鬆弛，導致眼下的支撐力變弱，就容易使眼下產生鼓鼓、腫腫的眼袋。 從上述可知，眼袋屬於立體的構造，所以無論怎麼用化妝品遮擋，其實都很難蓋掉，反而更顯勞累和妝感重，與清透年輕的妝感背道而馳，這是許多「眼袋族」最大的困擾之一。此外，眼袋的另一個特徵是不笑時會變明顯，而當大笑時因臉部肌肉收縮，眼袋就會變小或消失。 三種常見的眼袋類型： 1.天生型眼袋 先天遺傳性形成的眼袋，常見像是眼眶脂肪過多，導致眼窩脂肪突出形成眼袋；另一種常見的天生型眼袋是因為眼輪匝肌天生發達，使肌肉會隨著面部動作變凸、變明顯，這類型的眼袋一般年輕時就會出現，難以透過日常保養改善。 2.暫時型眼袋 又被稱為「水腫型眼袋」或俗稱「泡泡眼」，主要是由於前一天熬夜、喝酒、大哭或攝取過多鹽分等因素，導致隔天起床眼袋容易浮腫，屬於假性眼袋，通常幾個小時後就會改善。 3.老化型眼袋 隨著年齡增長或長期過度用眼，眼下肌膚的膠原蛋白流失，使得眼下的支撐力變弱，眼周脂肪隨地心引力向下滑落，形成下垂、突起的眼袋，部分個案也會合併淚溝及黑眼圈問題。 眼袋手術後注意事項： 1.每日皆須清潔傷口並換藥，至少3次。 2.若出現眼睛乾澀或發癢，可適度使用眼藥水滋潤眼球。 3.術後保持頭高腳低以利消除腫脹瘀青，術後冰敷2天，後續溫敷，每次約15~20分鐘。 4.約術後5~7天方可拆線。 5.術後避免服用刺激性食物，如抽菸、喝酒，不利於傷口癒合。