Массивная локализованная лимфедема (млл) или так называемая псевдосаркома - это явление вторичной лимфедемы, развивающейся вследствие ожирения, обусловленного нарушением лимфодренажа. MLL-это крупное доброкачественное опухолевое образование, связанное с переходом богатой белками жидкости в интерстициальное пространство с последующей активацией пролиферации интерстициальных клеток. Прогрессирующий рост ИИ в конечном итоге может привести к чрезвычайно большой массе, что затрудняет повседневную деятельность за счет ограничения подвижности, а также повышает риск повторного возникновения инфекций.Псевдосаркома-достаточно редкое заболевание, встречающееся среди населения, но по мере роста распространенности ожирения растет и заболеваемость больных.Важно учитывать, что клинические, гистологические и рентгенологические картины млл выглядят как злокачественные новообразования. Знание различий между этим состоянием и другими опухолями, помогает врачу быстро дифференцировать псевдосаркому и поставить правильный диагноз.Введем клиническое наблюдение за млл обработкой всей медиальной поверхности правого бедра с переходом на переднюю и заднюю поверхности

Introduction. Fibroadenomas (FA) are the most common benign breast neoplasms that are diagnosed in 25% of women. Dissatisfaction with the size of the breast and the desire to increase it occurs in 40%. For this reason, in the practice of a plastic surgeon, there are cases when the patient wants to remove fibroadenomas (FA) and increase the size of the breast. In this situation, there are two options for managing the patient- the simultaneous execution of two operations and the delayed one.Aim. To evaluate the possibility of simultaneous FA removal and augmentation mammoplasty, to analyze possible complications and methods of their correction.Materials and methods. We have analyzed the experience of simultaneous interventions of FA removal and augmentation mammoplasty on the example of 10 cases performed in the period from 2014-2019, as well as FA removal after implant placement-3 cases.Results. Performing a simultaneous operation has advantages due to the minimization of injuries (the ability to perform from a single access - submammary or periareolar), reducing psychological stress and better cosmetic effect. Two patients had postoperative complications in the form of capsular contracture, manifested in the asymmetry of the mammary glands, corrected by performing capsulotomy and forming a new submammary fold. When performing invasive diagnostic tests and surgical intervention in three patients after endoprosthesis augmentation mammoplasty, extreme caution was required due to the risk of violating the integrity of the implant. It was found that the incision of the posterior leaf of the MJ capsule with a large number of removed neoplasms in the postoperative period leads to the development of breast asymmetry. The fact of FA recurrence was also confirmed (2 patients), who subsequently underwent repeated surgical intervention.Conclusion. Performing simultaneous operations for benign breast tumors can be surely practiced by plastic surgeons, including as one of the options for simultaneous treatment of breast FA and augmentation mammoplasty. The occurrence of FA in the long-term period after breast augmentation surgery is associated with difficulties in diagnostics (mammography and fine needle aspiration biopsy under the control of ultrasound), as well as in the course of surgery itself, due to the presence of the implant and the risk of violation of its integrity.