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Biplanar Technique for Breast Implant Replacement through Mastectomy Scar
BACKGROUND: Implant-based breast reconstruction is the most commonly used modality for breast reconstruction. A 2-stage reconstruction is employed when the skin envelope is insufficient. In the first stage, a tissue expander is placed in a pocket created beneath the pectoralis major muscle and an ac...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7209901/ https://www.ncbi.nlm.nih.gov/pubmed/32440399 http://dx.doi.org/10.1097/GOX.0000000000002702 |
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author | Kruchevsky, Dani Tobias, Tal Halperin Ben-Ami, Tamar Shoufani, Aziz |
author_facet | Kruchevsky, Dani Tobias, Tal Halperin Ben-Ami, Tamar Shoufani, Aziz |
author_sort | Kruchevsky, Dani |
collection | PubMed |
description | BACKGROUND: Implant-based breast reconstruction is the most commonly used modality for breast reconstruction. A 2-stage reconstruction is employed when the skin envelope is insufficient. In the first stage, a tissue expander is placed in a pocket created beneath the pectoralis major muscle and an acellular dermal matrix (ADM). In the second stage, the expander is replaced with a permanent implant. Though the second stage is safer, some studies have published an immediate complication rate of up to 11.4%, and even higher in the event of prior radiotherapy. METHODS: We present a novel biplanar technique for implant replacement through the mastectomy scar. The goal of our technique is to make incisions of the skin and the incorporated ADM in 2 separate planes, hopefully lowering the risk for dehiscence, deep infection, and reconstruction failure. We conducted a retrospective review of patients who underwent tissue expander or implant replacement surgery using the biplanar technique between January 2012 and January 2018 by the senior author. RESULTS: Eleven consecutively presenting patients underwent 8 tissue expanders and 6 silicone implant replacement surgeries. Three patients had received prior radiation therapy in the operated breast. None of the patients had complications nor needed a revision surgery. CONCLUSIONS: The biplanar technique for implant or tissue expander replacement through the mastectomy scar following breast reconstruction shows promising results in our series of patients and may prove useful in reducing postoperative incisional dehiscence, deep infection, and implant exposure. Nonetheless, further large-scale studies are required to evaluate the effectiveness of this technique. |
format | Online Article Text |
id | pubmed-7209901 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-72099012020-05-21 Biplanar Technique for Breast Implant Replacement through Mastectomy Scar Kruchevsky, Dani Tobias, Tal Halperin Ben-Ami, Tamar Shoufani, Aziz Plast Reconstr Surg Glob Open Ideas and Innovations BACKGROUND: Implant-based breast reconstruction is the most commonly used modality for breast reconstruction. A 2-stage reconstruction is employed when the skin envelope is insufficient. In the first stage, a tissue expander is placed in a pocket created beneath the pectoralis major muscle and an acellular dermal matrix (ADM). In the second stage, the expander is replaced with a permanent implant. Though the second stage is safer, some studies have published an immediate complication rate of up to 11.4%, and even higher in the event of prior radiotherapy. METHODS: We present a novel biplanar technique for implant replacement through the mastectomy scar. The goal of our technique is to make incisions of the skin and the incorporated ADM in 2 separate planes, hopefully lowering the risk for dehiscence, deep infection, and reconstruction failure. We conducted a retrospective review of patients who underwent tissue expander or implant replacement surgery using the biplanar technique between January 2012 and January 2018 by the senior author. RESULTS: Eleven consecutively presenting patients underwent 8 tissue expanders and 6 silicone implant replacement surgeries. Three patients had received prior radiation therapy in the operated breast. None of the patients had complications nor needed a revision surgery. CONCLUSIONS: The biplanar technique for implant or tissue expander replacement through the mastectomy scar following breast reconstruction shows promising results in our series of patients and may prove useful in reducing postoperative incisional dehiscence, deep infection, and implant exposure. Nonetheless, further large-scale studies are required to evaluate the effectiveness of this technique. Wolters Kluwer Health 2020-04-24 /pmc/articles/PMC7209901/ /pubmed/32440399 http://dx.doi.org/10.1097/GOX.0000000000002702 Text en Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Ideas and Innovations Kruchevsky, Dani Tobias, Tal Halperin Ben-Ami, Tamar Shoufani, Aziz Biplanar Technique for Breast Implant Replacement through Mastectomy Scar |
title | Biplanar Technique for Breast Implant Replacement through Mastectomy Scar |
title_full | Biplanar Technique for Breast Implant Replacement through Mastectomy Scar |
title_fullStr | Biplanar Technique for Breast Implant Replacement through Mastectomy Scar |
title_full_unstemmed | Biplanar Technique for Breast Implant Replacement through Mastectomy Scar |
title_short | Biplanar Technique for Breast Implant Replacement through Mastectomy Scar |
title_sort | biplanar technique for breast implant replacement through mastectomy scar |
topic | Ideas and Innovations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7209901/ https://www.ncbi.nlm.nih.gov/pubmed/32440399 http://dx.doi.org/10.1097/GOX.0000000000002702 |
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