Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women
Archives of Plastic Surgery
;
: 366-373, 2014.
Article
in English
| WPRIM
| ID: wpr-227945
ABSTRACT
BACKGROUND:
The advent of skin-sparing mastectomy has allowed for the reconstruction of the breast and nipple with improved cosmesis. However, the nipple-areolar complex (NAC) in Asian patients is more pigmented and scars easily. Therefore, commonly described incisions tend to result in poor aesthetic outcomes in Asian patients with breast cancer.METHODS:
We describe an algorithmic approach to skin-sparing mastectomy incisions in Asian patients on the basis of the location of the biopsy scar and the tumor site and size. Four incision types are described peri-areolar, a peri-areolar incision with a second distant skin paddle, "racquet handle," and peri-areolar with adjacent skin excision.RESULTS:
281 immediate breast reconstructions were performed between May 2001 and February 2012 after skin-sparing mastectomy. The mastectomy incisions used included the peri-areolar design (n=124, 44%), peri-areolar design with a second distant skin paddle (n=39, 14%), "racquet handle" (n=21, 7.5%), and peri-areolar design with adjacent skin excision (n=42, 14%). The traditional elliptical incision and other variants where the NAC outline was not preserved were performed in the remaining 55 patients. The average follow-up was 44.7 months during which there was 1 case of total flap loss and 7 cases of partial flap necrosis; all remaining flaps survived. 24% of the patients (68/281) underwent subsequent nipple reconstruction.CONCLUSIONS:
Our algorithm avoids breast incisions that are randomly placed or excessively long and prevents the unnecessary sacrifice of normal breast skin. This allows skin-sparing mastectomy and immediate breast reconstruction to be performed with a consistently achievable aesthetic result in Asian women without neglecting oncological safety.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Asia
/
Skin
/
Biopsy
/
Breast
/
Breast Neoplasms
/
Follow-Up Studies
/
Cicatrix
/
Mammaplasty
/
Asian People
/
Esthetics
Type of study:
Observational study
/
Prognostic study
Limits:
Female
/
Humans
Country/Region as subject:
Asia
Language:
English
Journal:
Archives of Plastic Surgery
Year:
2014
Type:
Article
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