Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Kruchevsky, Dani, Tobias, Tal, Halperin Ben-Ami, Tamar, Shoufani, Aziz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
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
_version_ 1783531182372159488
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
work_keys_str_mv AT kruchevskydani biplanartechniqueforbreastimplantreplacementthroughmastectomyscar
AT tobiastal biplanartechniqueforbreastimplantreplacementthroughmastectomyscar
AT halperinbenamitamar biplanartechniqueforbreastimplantreplacementthroughmastectomyscar
AT shoufaniaziz biplanartechniqueforbreastimplantreplacementthroughmastectomyscar