Document Detail


Respecting the aesthetic unit in autologous breast reconstruction improves the outcome.
MedLine Citation:
PMID:  16651936     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In postmastectomy breast reconstruction, a patchwork-like appearance and a double-bubble phenomenon may result from scar contracture and the possible destruction of the normal inframammary fold during mastectomy. Restoring an age-related breast ptosis can be difficult, and often contralateral breast surgery has to be performed to achieve symmetry. The purpose of this article is to present a technique that respects the aesthetic unit in autologous reconstruction, improves the outcome, and minimizes secondary surgery.
METHODS: The area between the resected mastectomy scar and the marked inframammary fold is deepithelialized. The inferior skin margin of the flap is sutured to the lower line of the deepithelialized area, which corresponds to the inframammary fold of the contralateral side. The degree of ptosis can be adjusted by insetting greater or lesser amounts of skin. From December of 2000 to June of 2004, 12 patients underwent secondary breast reconstruction using this technique. The patients' ages ranged from 39 to 63 years (median, 51 years). Three patients had reduction mammaplasty of the contralateral breast.
RESULTS: Mean patient follow-up was 14.7 months (range, 4 to 45 months). There were no free flap failures. Cosmetic evaluation of the reconstructed breasts by two independent plastic surgeons showed good results with regard to symmetry in 10 patients and fair results in two patients. Concerning visibility of the inferior scar, 11 patients had a good result and one patient had a fair result. All patients had a good result in terms of age-appropriate ptosis.
CONCLUSIONS: The authors' technique facilitates the formation of an age-appropriate ptosis. Altogether, the aesthetic unit of the breast is restored.
Authors:
Petra Pülzl; Thomas Schoeller; Gottfried Wechselberger
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  117     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-02     Completed Date:  2006-05-23     Revised Date:  2011-02-16    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1685-91; discussion 1692-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Plastic and Reconstructive Surgery, Innsbruck Medical University, Ludwig Boltzmann Institute for Quality Control in Plastic and Reconstructive Surgery, Innsbruck, Austria. petra.puelzl@uibk.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Cicatrix
Esthetics*
Female
Humans
Ligaments / surgery
Mammaplasty / methods*
Middle Aged
Reoperation
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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