ABSTRACT
Objective:To evaluate the aesthetic results of bilateral breast symmetry after reduction mammaplasty, we proposed a handheld 3D scanner-based evaluation method to achieve the desired aesthetic effects.Methods:From June 2018 to June 2019, a total of 56 female patients with an average age of 34 years (18 to 56 years) requested for bilateral breast reduction in the Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Three-dimensional scans were performed intraoperatively in 27 cases in study group, and symmetry adjustments were made during breast contouring based on the analysis results; in the control group, a total of 29 patients did not undergo three-dimensional scans intraoperatively. Three-dimensional scans were obtained from both groups 3 months after surgery to objectively assess breast symmetry. Six third-party physicians scored the two groups based on anonymous photographs of the patients in 5 dimensions of breast symmetry to assess the symmetry of the pre- and post-operative bilateral breasts.Results:The difference in breast volume in the study group was significantly smaller bilaterally than in the control group [35.26 (20.01, 55.61) vs 110.02 (43.52, 186.30) cm 3,U=221.00, P=0.001]. The results reported by the evaluators showed that all five aspects of breast symmetry measured by breast reduction were significantly improved in the study group compared to the preoperative period ( P<0.001) and were all statistically superior to the control group ( P<0.05). Conclusions:Intraoperative three-dimensional scanning technology presents a dependable method to facilitate in optimizing bilateral breast symmetry, which in turn provides an opportunity to enhance the aesthetic outcome after reduction mammoplasty.
ABSTRACT
RESUMEN Introducción: La reconstrucción mamaria inmediata disminuye el impacto psicológico del cáncer de mama y mejora la calidad de vida de las pacientes. Objetivo: Evaluar la simetría en la reconstrucción mamaria inmediata en el Instituto Nacional de Oncología y Radiobiología de Cuba. Método: Se realizó un estudio analítico y prospectivo, de cohorte incidente, en el Servicio de Cirugía Reconstructiva del Instituto Nacional de Oncología y Radiobiología de 2014 al 2017. Se incluyeron 41 pacientes que consintieron participar en el estudio. Se recogieron variables demográficas y onco-reconstructivas. Se utilizó un software creado en la institución para evaluar la simetría mamaria. Los datos se recogieron de la historia clínica. Se aplicaron el test de Chi-cuadrado corregido y la razón de momios para el análisis estadístico. Resultados: El 30,2 por ciento de mujeres reconstruidas pertenecieron al grupo de 30 a 39 años; el 46,3 por ciento tenían sobrepeso. La mejor simetría se encontró con las técnicas oncoplásticas (31,7 por ciento), seguida de la mastectomía ahorradora de piel. La técnica de expansión tisular con la mastectomía presentó mayores complicaciones (63,6 por ciento) y menor simetría. La necrosis parcial de piel fue la mayor complicación en 7,3 por ciento y estuvo relacionadas con las técnicas ahorradoras de piel. Conclusiones: Evaluar de forma objetiva la simetría mamaria permitió conocer la efectividad de las técnicas quirúrgicas reconstructivas. Con las técnicas de cirugía oncoplástica y mastectomía ahorradora de piel se obtuvieron los mejores resultados estéticos y pocas complicaciones. La expansión mamaria inmediata con una mastectomía radical modificada no ofrece ninguna ventaja(AU)
ABSTRACT Introduction: Immediate breast reconstruction reduces the psychological impact of breast cancer and improves the quality of life of patients. Objective: To assess symmetry in immediate breast reconstruction at the of Cuba. Method: An analytical and prospective study of incident cohort was carried out in the reconstructive surgery service at the National Institute of Oncology and Radiobiology (INOR), from 2014 to 2017. Forty-one patients who consented to participate in the study were included. Demographic and oncoreconstructive variables were collected. A software created in the institution was used to assess breast symmetry. The data were collected from the medical histories. The corrected chi-square test and odds ratio were applied for statistical analysis. Results: 30.2 percent of women who received reconstruction belonged to the age group 30-39 years; 46.3 percent were overweight. The best symmetry was found with oncoplastic techniques (31.7 percent), followed by skin-sparing mastectomy. The tissue expansion technique with mastectomy presented greater complications (63.6 percent) and less symmetry. Partial skin necrosis was the major complication, accounting for 7.3 percent of the cases, and was related to skin-sparing techniques. Conclusions: Objectively evaluating breast symmetry allowed us to know the effectiveness of reconstructive surgical techniques. With oncoplastic surgery and skin-sparing mastectomy techniques, the best aesthetic outcomes and few complications were obtained. Immediate breast expansion with a modified radical mastectomy offers no benefit(AU)