Immediate bilateral breast reconstruction after skinsparing mastectomy: cross-sectional incision and implants in mixed plane
Introduction: Complications in immediate breast reconstruction after skin-preserving mastectomies are recurrent. The authors describe conduct to reduce them and improve the anatomical/esthetic result using implants. The objective is to reduce the incidence of areolar necrosis, improve breast project...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Revinter Publicações Ltda.
2023-05-01
|
| Series: | Revista Brasileira de Cirurgia Plástica |
| Subjects: | |
| Online Access: | http://www.rbcp.org.br/export-pdf/3251/463-en.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850053119988203520 |
|---|---|
| author | Antonio Roberto Bozola Alexandre Caroni Bozola Italo Bozola |
| author_facet | Antonio Roberto Bozola Alexandre Caroni Bozola Italo Bozola |
| author_sort | Antonio Roberto Bozola |
| collection | DOAJ |
| description | Introduction: Complications in immediate breast reconstruction after skin-preserving mastectomies are recurrent. The authors describe conduct to reduce them and improve the anatomical/esthetic result using implants. The objective is to reduce the incidence of areolar necrosis, improve breast projection in reconstructions with submuscular implants, recover partial or total sensitivity, and facilitate symmetrization.
Method: The mastectomy involves a lateral transverse incision from the areolar border to the armpit. Repair with implants included in a mixed plane by divulsion of the pectoral muscle, dividing it into two portions in the direction of its fibers, the association of the serratus muscle fascia and inferior/lateral subcutaneous tissue, and/or pectoralis minor muscle in the superolateral area. The incision is sutured when there is no breast ptosis or superimposed by de-epidermization of one of the borders, which may include a reduction in diameter and relocation of the areola. Or fusiform de-epidermization of the periareolar skin and medially to it. The contralateral risk-reducing mastectomy had a similar procedure, improving symmetry.
Results: 106 patients (212 breasts) were operated on with satisfactory results and complications due to infection, positioning of the implants on the learning curve, and surface irregularities.
Conclusion: Immediate breast reconstruction after skin-preserving mastectomy by the proposed method is a possible option, obtaining good breast symmetrization and projection, return of sensitivity, and absence of total necrosis of the areola. |
| format | Article |
| id | doaj-art-231dededb30e49039cb448506a7b2d65 |
| institution | DOAJ |
| issn | 1983-5175 2177-1235 |
| language | English |
| publishDate | 2023-05-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Revista Brasileira de Cirurgia Plástica |
| spelling | doaj-art-231dededb30e49039cb448506a7b2d652025-08-20T02:52:37ZengThieme Revinter Publicações Ltda.Revista Brasileira de Cirurgia Plástica1983-51752177-12352023-05-013801010810.5935/2177-1235.2023RBCP0463-ENImmediate bilateral breast reconstruction after skinsparing mastectomy: cross-sectional incision and implants in mixed planeAntonio Roberto Bozola0Alexandre Caroni Bozola1Italo Bozola2Faculdade Estadual de Medicina de São José do Rio Preto, Divisão de Cirurgia Plástica, São José do Rio Preto, SP, BrazilFaculdade Estadual de Medicina de São José do Rio Preto, Divisão de Cirurgia Plástica, São José do Rio Preto, SP, BrazilFaculdade Estadual de Medicina de São José do Rio Preto, Divisão de Cirurgia Plástica, São José do Rio Preto, SP, BrazilIntroduction: Complications in immediate breast reconstruction after skin-preserving mastectomies are recurrent. The authors describe conduct to reduce them and improve the anatomical/esthetic result using implants. The objective is to reduce the incidence of areolar necrosis, improve breast projection in reconstructions with submuscular implants, recover partial or total sensitivity, and facilitate symmetrization. Method: The mastectomy involves a lateral transverse incision from the areolar border to the armpit. Repair with implants included in a mixed plane by divulsion of the pectoral muscle, dividing it into two portions in the direction of its fibers, the association of the serratus muscle fascia and inferior/lateral subcutaneous tissue, and/or pectoralis minor muscle in the superolateral area. The incision is sutured when there is no breast ptosis or superimposed by de-epidermization of one of the borders, which may include a reduction in diameter and relocation of the areola. Or fusiform de-epidermization of the periareolar skin and medially to it. The contralateral risk-reducing mastectomy had a similar procedure, improving symmetry. Results: 106 patients (212 breasts) were operated on with satisfactory results and complications due to infection, positioning of the implants on the learning curve, and surface irregularities. Conclusion: Immediate breast reconstruction after skin-preserving mastectomy by the proposed method is a possible option, obtaining good breast symmetrization and projection, return of sensitivity, and absence of total necrosis of the areola.http://www.rbcp.org.br/export-pdf/3251/463-en.pdfbreastprostheses and implantsmammaplastybreast neoplasmsreconstructive surgical procedures |
| spellingShingle | Antonio Roberto Bozola Alexandre Caroni Bozola Italo Bozola Immediate bilateral breast reconstruction after skinsparing mastectomy: cross-sectional incision and implants in mixed plane Revista Brasileira de Cirurgia Plástica breast prostheses and implants mammaplasty breast neoplasms reconstructive surgical procedures |
| title | Immediate bilateral breast reconstruction after skinsparing mastectomy: cross-sectional incision and implants in mixed plane |
| title_full | Immediate bilateral breast reconstruction after skinsparing mastectomy: cross-sectional incision and implants in mixed plane |
| title_fullStr | Immediate bilateral breast reconstruction after skinsparing mastectomy: cross-sectional incision and implants in mixed plane |
| title_full_unstemmed | Immediate bilateral breast reconstruction after skinsparing mastectomy: cross-sectional incision and implants in mixed plane |
| title_short | Immediate bilateral breast reconstruction after skinsparing mastectomy: cross-sectional incision and implants in mixed plane |
| title_sort | immediate bilateral breast reconstruction after skinsparing mastectomy cross sectional incision and implants in mixed plane |
| topic | breast prostheses and implants mammaplasty breast neoplasms reconstructive surgical procedures |
| url | http://www.rbcp.org.br/export-pdf/3251/463-en.pdf |
| work_keys_str_mv | AT antoniorobertobozola immediatebilateralbreastreconstructionafterskinsparingmastectomycrosssectionalincisionandimplantsinmixedplane AT alexandrecaronibozola immediatebilateralbreastreconstructionafterskinsparingmastectomycrosssectionalincisionandimplantsinmixedplane AT italobozola immediatebilateralbreastreconstructionafterskinsparingmastectomycrosssectionalincisionandimplantsinmixedplane |