Cargando…
Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women
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 aesthet...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Plastic and Reconstructive Surgeons
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113696/ https://www.ncbi.nlm.nih.gov/pubmed/25075359 http://dx.doi.org/10.5999/aps.2014.41.4.366 |
_version_ | 1782328324050124800 |
---|---|
author | Tan, Bien-Keem Chim, Harvey Ng, Zhi Yang Ong, Kong Wee |
author_facet | Tan, Bien-Keem Chim, Harvey Ng, Zhi Yang Ong, Kong Wee |
author_sort | Tan, Bien-Keem |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4113696 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | The Korean Society of Plastic and Reconstructive Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-41136962014-07-29 Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women Tan, Bien-Keem Chim, Harvey Ng, Zhi Yang Ong, Kong Wee Arch Plast Surg Original Article 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. The Korean Society of Plastic and Reconstructive Surgeons 2014-07 2014-07-15 /pmc/articles/PMC4113696/ /pubmed/25075359 http://dx.doi.org/10.5999/aps.2014.41.4.366 Text en Copyright © 2014 The Korean Society of Plastic and Reconstructive Surgeons http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Tan, Bien-Keem Chim, Harvey Ng, Zhi Yang Ong, Kong Wee Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women |
title | Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women |
title_full | Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women |
title_fullStr | Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women |
title_full_unstemmed | Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women |
title_short | Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women |
title_sort | aesthetic design of skin-sparing mastectomy incisions for immediate autologous tissue breast reconstruction in asian women |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113696/ https://www.ncbi.nlm.nih.gov/pubmed/25075359 http://dx.doi.org/10.5999/aps.2014.41.4.366 |
work_keys_str_mv | AT tanbienkeem aestheticdesignofskinsparingmastectomyincisionsforimmediateautologoustissuebreastreconstructioninasianwomen AT chimharvey aestheticdesignofskinsparingmastectomyincisionsforimmediateautologoustissuebreastreconstructioninasianwomen AT ngzhiyang aestheticdesignofskinsparingmastectomyincisionsforimmediateautologoustissuebreastreconstructioninasianwomen AT ongkongwee aestheticdesignofskinsparingmastectomyincisionsforimmediateautologoustissuebreastreconstructioninasianwomen |