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Pre-expansion before risk reducing mastectomy combined with lipomodelling to enhance results from implant based reconstruction.
MedLine Citation:
PMID:  21925988     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Implant based breast reconstruction after risk reducing mastectomy (RRM) is challenging as implants are inadequately covered in their lower pole. Also complication rates with one stage procedures are significant. We describe a novel method of pre-expansion by inserting subpectoral anatomical expandable implants to prepare the breast mound before RRM is carried out. Lipomodelling is later used to enhance the overall result of the reconstruction. Six patients who were BRCA 1 mutation carriers requested bilateral RRM. Median age was 31. All were non-smokers. Anatomical expandable implants were inserted via an inframammary incision and were expanded in the next two months. RRM was carried out 67-13 months later and was followed by lipomodelling seven months afterwards. Four patients had a nipple sparing mastectomy. In three cases access was via the previous inframammary scar. In all cases complete implant cover had been achieved. There were no early postoperative complications but one patient has developed grade III capsular contracture on the side of previous wide local tumour excision and radiotherapy. Five patients have so far undergone post-mastectomy lipomodelling to improve breast contour. In conclusion, we believe that our technique provides better aesthetic results with reduced complication rates for these patients.
Authors:
E Katerinaki; T Sircar; F Fatah
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-16
Journal Detail:
Title:  Journal of plastic, reconstructive & aesthetic surgery : JPRAS     Volume:  -     ISSN:  1878-0539     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264239     Medline TA:  J Plast Reconstr Aesthet Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Plastic Surgery, Birmingham City Hospital, Dudley Road, Birmingham B18 7QH, UK.
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