Ricaño RR, Vázquez Lara CLG

Language: Spanish
References: 26
Page: 120-126
PDF size: 315.05 Kb.

ABSTRACT

Therapeutic and prophylactic mastectomy in patients with breast cancer, with mammary hypertrophy and ptosis, requires a careful selection of the reconstructive procedure. The procedures described need more than one surgery, microsurgery, or acellular matrix, thus increasing costs and morbidity. The aim of this work is to present a technique which allows for mastectomy and reconstruction in hypertrophic and ptosis breasts in one integral surgery. For the reconstruction, we added the autograft of the nipple-areola complex to the technique originally described by Bostwick. The procedure was performed on 6 patients (11 breasts) with D or DD cup with mammary ptosis grade 2 or 3. The weight was 551.9 ± 241.5. The only complication observed was infection in one breast. The general aspect of the reconstruction and the position and pigmentation of the nipple-areola complex were scored as good in all cases. Nipple projection was scored as good in two cases and as moderate in the rest. We conclude that the reconstruction with the Bostwick technique, using autograft of the nipple-areola complex in one surgery in hypertrophic and ptosis breasts for therapeutic or prophylactic reasons, is reproducible, faster and safer, and offers lower morbidity, risk and cost.

REFERENCES

1. Vlajcic Z, Rado Z, Stanec S, Stanec Z. Nipple-areola complex preservation. Plast Reconstr Surg 2006; 118 (6): 1493-1495; author reply 1495-1496.

2. Spear SL, Hannan CM, Willey SC, Cocilovo C. Nipple-sparing mastectomy. Plast Reconstr Surg 2009; 123 (6): 1665-1673.

3. Moyer HR, Ghazi B, Daniel JR, Gasgarth R, Carlson GW. Nipple-sparing mastectomy: technical aspects and aesthetic outcomes. Ann Plast Surg 2012; 68 (5): 446-450.

4. Stolier AJ, Levine EA. Reducing the risk of nipple necrosis: technical observations in 340 nipple-sparing mastectomies. Breast J 2013; 19 (2): 173-179.

5. Spear SL, Rottman SJ, Seiboth LA, Hannan CM. Breast reconstruction using a staged nipple-sparing mastectomy following mastopexy or reduction. Plast Reconstr Surg 2012; 129 (3): 572-581.

6. Wellisch DK, Schain WS, Noone RB, Little JW 3rd. The psychological contribution of nipple addition in breast reconstruction. Plast Reconstr Surg 1987; 80 (5): 699-704.

7. DellaCroce FJ, Blum CA, Sullivan SK, Stolier A, Trahan C, Wise MW et al. Nipple-sparing mastectomy and ptosis: perforator flap breast reconstruction allows full secondary mastopexy with complete nipple areolar repositioning. Plast Reconstr Surg 2015; 136 (1): 1e-9e.

8. Broer N, Narayan D, Lannin D, Grube B. A novel technique for nipple-sparing mastectomy and immediate reconstruction in patients with macromastia. Plast Reconstr Surg 2010; 126 (2): 89e-92e.

9. Ladizinsky DA, Sandholm PH, Jewett ST, Shahzad F, Andrews K. Breast reconstruction with the Bostwick autoderm technique. Plast Reconstr Surg 2013; 132 (2): 261-270.

10. Bostwick J 3rd. Breast reconstruction after mastectomy. Semin Surg Oncol 1988; 4 (4): 274-279.

11. Carlson GW, Bostwick J 3rd, Styblo TM, Moore B, Bried JT, Murray DR et al. Skin-sparing mastectomy. Oncologic and reconstructive considerations. Ann Surg 1997; 225 (5): 570-575; discussion 575-578.

12. Losken A, Collins BA, Carlson GW. Dual-plane prosthetic reconstruction using the modified wise pattern mastectomy and fasciocutaneous flap in women with macromastia. Plast Reconstr Surg 2010; 126 (3): 731-738.

13. Nava MB, Cortinovis U, Ottolenghi J, Riggio E, Pennati A, Catanuto G et al. Skin-reducing mastectomy. Plast Reconstr Surg 2006; 118 (3): 603-610; discussion 611-613.

14. Regnault P. Breast ptosis. Definition and treatment. Clin Plast Surg 1976; 3 (2): 193-203.

15. Ahmed AK, Hahn DE, Hage JJ, Bleiker EM, Woerdeman LA. Temporary banking of the nipple-areola complex in 97 skin-sparing mastectomies. Plast Reconstr Surg 2011; 127 (2): 531-539.

16. Salibian AH, Harness JK, Mowlds DS. Inframammary approach to nipple-areola-sparing mastectomy. Plast Reconstr Surg 2013; 132 (5): 700e-708e.

17. Wise RJ. A preliminary report on a method of planning the mammaplasty. Plast Reconstr Surg (1946) 1956; 17 (5): 367-375.

18. Chun YS, Verma K, Rosen H, Lipsitz S, Morris D, Kenney P et al. Implant-based breast reconstruction using acellular dermal matrix and the risk of postoperative complications. Plast Reconstr Surg 2010; 125 (2): 429-436.

19. Kim JY, Davila AA, Persing S, Connor CM, Jovanovic B, Khan SA et al. A meta-analysis of human acellular dermis and submuscular tissue expander breast reconstruction. Plast Reconstr Surg 2012; 129 (1): 28-41.

20. Liu AS, Kao HK, Reish RG, Hergrueter CA, May JW Jr, Guo L. Postoperative complications in prosthesis-based breast reconstruction using acellular dermal matrix. Plast Reconstr Surg 2011; 127 (5): 1755-1762.

21. DellaCroce FJ, Sullivan SK, Trahan C. Stacked deep inferior epigastric perforator flap breast reconstruction: a review of 110 flaps in 55 cases over 3 years. Plast Reconstr Surg 2011; 127 (3): 1093-1099.

22. DellaCroce FJ, Sullivan SK, Trahan C, Jenkins CE. Body lift perforator flap breast reconstruction: a review of 100 flaps in 25 cases. Plast Reconstr Surg 2012; 129 (3): 551-561.

23. Bostwick J. Prophylactic (risk-reducing) mastectomy and reconstruction. In: plastic and reconstructive breast surgery. 2nd ed. St. Louis, MO: Quality Medical Pub.; 2000. pp. 1369-1373. ISBN 9781576261040.

24. Bostwick J 3rd. Breast reconstruction--from never to now. J Am Coll Surg 2001; 192 (1): 69-70.

25. Kobraei EM, Nimtz J, Wong L, Buseman J, Kemper P, Wright H et al. Risk factors for adverse outcome following skin-sparing mastectomy and immediate prosthetic reconstruction. Plast Reconstr Surg 2012; 129 (2): 234e-241e.

26. Nava MB, Ottolenghi J, Pennati A, Spano A, Bruno N, Catanuto G et al. Skin/nipple sparing mastectomies and implant-based breast reconstruction in patients with large and ptotic breast: oncological and reconstructive results. Breast 2012; 21 (3): 267-271.