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Secondary Techniques in Breast Reconstruction Refinement
- Source :
- Plastic and Reconstructive Surgery. 128:1015-1024
- Publication Year :
- 2011
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2011.
-
Abstract
- BACKGROUND Techniques in breast reconstruction have vastly improved with natural feeling, aesthetically pleasing breasts created through transfer of free or pedicled tissue. Traditional flap designs incorporate a skin paddle that leaves a "patch," which can be fairly large on the nouveau breast, clearly delineating the boundaries between the reconstruction and the native skin. In this article, the authors discuss the operative technique and present a clinical series of patients undergoing the periareolar advancement flap procedure. This technique reduces the skin paddle either to a circumferential areola-size area onto which the nipple can be simultaneously reconstructed (type I) or a single linear scar (type II) across the breast mound, thus enhancing the aesthetic appearance of the reconstructed breast. METHODS A retrospective review of all patients between 2007 and 2009 undergoing periareolar advancement flaps under the care of the senior author (M.S.C.) was performed. Type of reconstruction, staging of procedures, additional operations, and complications were recorded. RESULTS Fifteen patients had a type I procedure and six patients had a type II procedure. There were no major complications. One patient had minor nipple scabbing that resolved. All type I patients had concomitant nipple reconstructions at the time of their periareolar advancement flap. CONCLUSIONS The periareolar advancement flap is a useful technique to include in the range of secondary revision procedures for further refinement of autologous breast reconstruction. It results in a sensate, more aesthetically pleasing breast. It has low complication rates and can be performed at the same time as a nipple reconstruction in type I patients. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
- Subjects :
- Adult
Graft Rejection
medicine.medical_specialty
Esthetics
Mammaplasty
Tissue Expansion
Breast Neoplasms
Risk Assessment
Surgical Flaps
Periareolar
Cohort Studies
Postoperative Complications
medicine
Humans
Major complication
Nipple reconstruction
Mastectomy
Aged
Retrospective Studies
Wound Healing
Retrospective review
business.industry
Graft Survival
Suture Techniques
Middle Aged
Skin paddle
Surgery
Treatment Outcome
Clinical question
Nipples
Female
business
Breast reconstruction
Follow-Up Studies
Subjects
Details
- ISSN :
- 00321052
- Volume :
- 128
- Database :
- OpenAIRE
- Journal :
- Plastic and Reconstructive Surgery
- Accession number :
- edsair.doi.dedup.....d683e088f2d1f465888838f69621c5a2
- Full Text :
- https://doi.org/10.1097/prs.0b013e31821e6d2c