I. What is a parastet?
Parametrium, as the name implies, is an extra breast. Under normal circumstances, women only have one pair of breasts, but some women also have breasts and nipples in other parts of the body besides the breasts. Embryology tells us that parametrium is brought from the fetus. In the sixth week of embryonic life, the ectodermal cells thicken on both sides of the ventral surface of the trunk, forming ridges that correspond to the curved line from the armpit to the groin, and these two ridges are called the mammary line, with 6-8 pairs of mammary primordia.
Under normal circumstances, except for the epidermis of one pair of breast primordia, which continues to thicken to form the future breast, the rest of them will degenerate and disappear in the 9th week of embryonic life, and the ones that do not degenerate are the parametrium.
Where do the parametrial breasts grow?
The incidence of parametrial breast is not very low, 1%-5%, and can occur in both men and women, the ratio of men to women is 1:5, and often has a family history of inheritance. They can also be found on the chest wall, abdominal wall, and occasionally on the ears, face, neck, upper arms, back, scapular area, groin, dorsal thighs, buttocks, and vulva, but they are rare.
How many types of parastomastia are there?
There are two types of parastomastia: fully developed and incompletely developed. Fully developed parametrium has both nipple and breast tissue, while incompletely developed parametrium has only areola or nipple, or may have only incompletely developed breast tissue without nipple, areola and duct system.
How to diagnose parametrial breast?
The diagnosis of parastomastia is not difficult. A fully developed parametrial breast is usually a bulge or mass with a diameter of 1 to 6 cm and a soft texture, with a nipple and areola visible in the center. It may increase in size during menstruation or lactation, with painful swelling or milk secretion. The incompletely developed parametrium is usually uncomfortable and is often overlooked, but the subcutaneous mass or nipple and areola are visible on physical examination. They are sometimes mistaken for armpit lipomas or enlarged lymph nodes in the armpit or for growths in the caudal part of the normal breast.
How is the treatment of parametrial breast?
The treatment principle for parametrial breasts is the same as that for normal breasts, no treatment is needed if there is no disease, especially if there are no symptoms, no glandular structure, only nipples and areolas. However, because the structure of the breast tissue of the parametrial breast is the same as that of the normal breast, the parametrial breast can also suffer from various diseases that can occur in the normal breast, such as hyperplasia, inflammation, and cancer.
Fat aspiration for removal of parametrial breast.
This surgical method is relatively simple. It is even more so if it can be guided by ultrasound. However, the simpler the surgery, the more attention needs to be paid to the details of the treatment. These details include: whether the shape of the surgical area is aesthetically pleasing, and preventing various complications after the surgery.
Fat aspiration + small incision paramastectomy.
Because these patients will have a small amount of glandular tissue, especially since some of the glandular tissue of the parametrium will also be attached to the skin of the armpit, a surgical incision is necessary to ensure that the gland can be removed intact. However, we will hide the surgical incision in the armpit, and inside the skin folds, so that the final healing wound will be indistinguishable from the normal armpit skin texture.
Fat aspiration + axillary incision for paramastrectomy and loose skin excision.
For moderate and severe parametrium that occurs in older (40-50 years age stage), or (and) fatty patients. In addition to removing the parametrium, we also have to consider the larger local depressions after surgery, as well as the aesthetic problems in the form of soft tissue laxity and sagging in the axillary area.
In the past, when people thought of surgery, they would think of the word “scar!” Scar is synonymous with “ugly and unsightly”. Wouldn’t you think of “rejuvenation surgery” in pursuit of beauty today?
In the past, people only focused on the eyes, facial skin, abdomen and other obvious parts of the rejuvenation surgery, in fact, the “failure” is precisely in the inconspicuous place, the loose upper arm, armpit is an important manifestation of aging. Therefore, it is a good idea to perform “armpit rejuvenation” while removing the secondary breasts. This “axillary rejuvenation” simply means some “extra” operations after the complete removal of the parametrium.
This includes: tightening and removing the sagging skin caused by aging; restoring a youthful and firm shape of the axillary area along the natural curves of women through surgical sutures like “body-tailoring”; and finally, using a “Z” reshaping to hide all skin incisions as well. Finally, all skin incisions are hidden in the armpit as before.