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Aesthetic Remodeling of the Healthy Breast in Breast Reconstruction Using Expanders and Implants

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Abstract

Background

Breast reconstruction using expanders and implants still is the most common surgical procedure in many hospitals. The most important factor in obtaining a satisfactory aesthetic result for both the patient and the surgeon is to achieve the greatest symmetry possible between the healthy breast and the reconstructed breast. To get a good result, it is necessary to make an exhaustive preoperative examination that facilitates selection of the most suitable technique for remodeling the healthy breast and to choose the most suitable expander for placement on the side to be reconstructed.

Methods

A retrospective study investigated 60 patients submitted to breast reconstruction between October 2005 and January 2008. The study analyzed the characteristics of the healthy breast (e.g., volume, ptosis), which is treated in the first part of the first operation. These characteristics are used later as a model for reconstructing the mastectomy side. The most adequate technique for remodeling the healthy breast based on its characteristics is indicated, as well as techniques not recommended for obtaining the desired symmetry.

Results

This study aimed to determine the basis for selecting the most appropriate technique to use in managing the healthy breast and obtaining the most aesthetic result in breast reconstruction. The healthy breast analysis allows an algorithm of indications to be elaborated based on the volume and degree of ptosis exhibited by the healthy breast. The healthy breast should resemble the reconstructed breast with its anatomic implant. In this study, the technique used most often to remodel the healthy breast was reduction surgery with a superomedial pedicle, and glandular flap (autoimplant) (30%). The results were highly satisfactory for both the patient and the surgeon.

Conclusions

Aesthetic remodeling of the healthy breast is the first surgical treatment in breast reconstruction in two stages using expanders and implants. The expander for reconstruction of the other breast then is selected according to the measurements of the healthy modified breast. This reproducible and simple model of breast reconstruction, with its detailed preoperative plan, allows clinicians to obtain a good aesthetic result for breast reconstruction patients.

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References

  1. Clough KB, O’Donoghue JM, Fitoussi AD, Nos C, Falcou MC (2001) Prospective evaluation of late cosmetic results following breast reconstruction: I. Implant reconstruction. Plast Reconstr Surg 107:1702

    Article  PubMed  CAS  Google Scholar 

  2. Cordeiro PG, McCarthy CM (2006) A single surgeon’s 12-year experience with tissue expander/implant breast reconstruction: Part II. An analysis of long-term complications, aesthetic outcomes, and patient satisfaction. Plast Reconstr Surg 118:832–839

    Article  PubMed  CAS  Google Scholar 

  3. Heden P, Jernbeck J, Hober M (2001) Breast augmentation with anatomical cohesive gel implants: the world’s largest current experience. Clin Plast Reconstr Surg 28:531

    CAS  Google Scholar 

  4. Behranwala KA, Dua RS, Ross GM, Ward A, A’Hern R, Gui GH (2006) The influence of radiotherapy on capsule formation and aesthetic outcome after immediate breast reconstruction using biodimensional anatomical expander implants. J Plast Reconstr Aesth Surg 59:1043–1051

    Article  CAS  Google Scholar 

  5. Tebbetts JB (2002) Breast implant selection based on patient’s tissue characteristics and dynamics: the TEPID approach. Plast Reconstr Surg 190:1396

    Article  Google Scholar 

  6. Tebbets JB (2001) Dual-plane (DP) breast augmentation: optimizing implant–soft tissue relationships in a wide range of breast types. Plast Reconstr Surg 107:1255–1272

    Article  Google Scholar 

  7. Benelli L (1988) Technique du round bloch. Rev Fr Chir Esthet 52:9

    Google Scholar 

  8. Bostwick JIII (1983) Aesthetic and reconstructive breast surgery. C V Mosby, St. Louis, MO, p 29

    Google Scholar 

  9. Finger RE, Vasquez B, Drew GS (1989) Given superomedial pedicle technique of reduction mammaplasty. Plast Reconstr Surg 83(3):471–480

    Article  PubMed  CAS  Google Scholar 

  10. Planas J (1988) Reduction mamaplasty: technical details. Aesth Plast Surg 4:143–208

    Google Scholar 

  11. Nahabedian MY, Tsangaris T, Momen B (2005) Breast reconstruction with the DIEP flap or the muscle-sparing (MS-2) free TRAM flap: Is there a difference? Plast Reconstr Surg 115:436–444 discussion 445–446

    Article  PubMed  Google Scholar 

  12. Becker H (1984) Breast reconstruction using inflatable breast implant with detachable reservoir. Plast Reconstr Surg 73:678

    Article  PubMed  CAS  Google Scholar 

  13. Spear SL, Spitller CJ (2001) Breast reconstruction with implants and expanders. Plast Reconstr Surg 107:177–188

    Article  PubMed  CAS  Google Scholar 

  14. Spear SL, Majidian A (1998) Immediate breast reconstruction in two stages using textured, integrated valve tissue expanders and breast implants: A retrospective review of 171 consecutive breast reconstructions from 1989 to 1996. Plast Reconstr Surg 101:53

    Article  PubMed  CAS  Google Scholar 

  15. Lejour M (1993) Vertical mammaplasty. Plast Reconstr Surg 92:985

    PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Instituto de Cirugía Estética y Plástica, C/Claudio Coello Nº 126 esc A bajo izda, CP-28006, Madrid, Spain

    Federico Mayo

  2. Unidad Médica Angloamericana, C/Conde de Aranda Nº1, 28001, Madrid, Spain

    Maria González Vecino

Authors
  1. Federico Mayo
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  2. Maria González Vecino
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Correspondence to Federico Mayo.

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Mayo, F., Vecino, M.G. Aesthetic Remodeling of the Healthy Breast in Breast Reconstruction Using Expanders and Implants. Aesth Plast Surg 33, 220–227 (2009). https://doi.org/10.1007/s00266-008-9300-1

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  • DOI: https://doi.org/10.1007/s00266-008-9300-1

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