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Secondary “Hybrid Reconstruction“ Concept with Silicone Implants After Autologous Breast Reconstruction – Is It Safe and Reasonable?

BACKGROUND: The use of autologous tissue for breast reconstructive surgery following mastectomy has become routine and allows for excellent symmetry and aesthetic results. However, in some cases, the amount of tissue available from the utilized flaps is not enough to achieve the desired outcome. The...

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Autores principales: Bach, Alexander D., Morgenstern, Isabelle H., Horch, Raymund E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238811/
https://www.ncbi.nlm.nih.gov/pubmed/32388530
http://dx.doi.org/10.12659/MSM.921329
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author Bach, Alexander D.
Morgenstern, Isabelle H.
Horch, Raymund E.
author_facet Bach, Alexander D.
Morgenstern, Isabelle H.
Horch, Raymund E.
author_sort Bach, Alexander D.
collection PubMed
description BACKGROUND: The use of autologous tissue for breast reconstructive surgery following mastectomy has become routine and allows for excellent symmetry and aesthetic results. However, in some cases, the amount of tissue available from the utilized flaps is not enough to achieve the desired outcome. The use of autologous fat grafting, as well as other techniques, has been described to deal with such problems. However, though well-established, these techniques may also fail to achieve the desired results. The aim of this study was to highlight the opportunity to improve aesthetic results using a secondary prosthesis underneath the previously used free flap and to examine whether this is a safe and reasonable procedure. MATERIAL/METHODS: In our study we included patients with unsatisfied aesthetic results after free flap procedures (DIEP, S-GAP, TMG, and FCI) between 2011 and 2018. In each case described, a secondary prosthesis was placed underneath the original flap in order to improve symmetry, shape and projection. Patient age, indication for surgery, adjuvant therapy, complications and outcomes have been registered. A 12-point scale was established to analyze patient satisfaction and aesthetic outcome. RESULTS: Overall “operative success” was achieved in all 13 patients (14 flaps) evaluated. At 12 months after reconstruction, all aesthetic scores collected were between good and excellent. In contrast to other studies, we chose a secondary approach for the flap augmentation and we used the epipectoral pocket for the placement of the implant. In our series, low rates of early and late post-operative complications were observed, with a high overall rate of satisfaction. CONCLUSIONS: The demonstrated “Hybrid Breast Reconstruction” approach, using an implant underneath a free flap autologous breast reconstruction, provided a safe and reliable option to optimize breast reconstruction outcomes.
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spelling pubmed-72388112020-06-01 Secondary “Hybrid Reconstruction“ Concept with Silicone Implants After Autologous Breast Reconstruction – Is It Safe and Reasonable? Bach, Alexander D. Morgenstern, Isabelle H. Horch, Raymund E. Med Sci Monit Clinical Research BACKGROUND: The use of autologous tissue for breast reconstructive surgery following mastectomy has become routine and allows for excellent symmetry and aesthetic results. However, in some cases, the amount of tissue available from the utilized flaps is not enough to achieve the desired outcome. The use of autologous fat grafting, as well as other techniques, has been described to deal with such problems. However, though well-established, these techniques may also fail to achieve the desired results. The aim of this study was to highlight the opportunity to improve aesthetic results using a secondary prosthesis underneath the previously used free flap and to examine whether this is a safe and reasonable procedure. MATERIAL/METHODS: In our study we included patients with unsatisfied aesthetic results after free flap procedures (DIEP, S-GAP, TMG, and FCI) between 2011 and 2018. In each case described, a secondary prosthesis was placed underneath the original flap in order to improve symmetry, shape and projection. Patient age, indication for surgery, adjuvant therapy, complications and outcomes have been registered. A 12-point scale was established to analyze patient satisfaction and aesthetic outcome. RESULTS: Overall “operative success” was achieved in all 13 patients (14 flaps) evaluated. At 12 months after reconstruction, all aesthetic scores collected were between good and excellent. In contrast to other studies, we chose a secondary approach for the flap augmentation and we used the epipectoral pocket for the placement of the implant. In our series, low rates of early and late post-operative complications were observed, with a high overall rate of satisfaction. CONCLUSIONS: The demonstrated “Hybrid Breast Reconstruction” approach, using an implant underneath a free flap autologous breast reconstruction, provided a safe and reliable option to optimize breast reconstruction outcomes. International Scientific Literature, Inc. 2020-05-10 /pmc/articles/PMC7238811/ /pubmed/32388530 http://dx.doi.org/10.12659/MSM.921329 Text en © Med Sci Monit, 2020 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Clinical Research
Bach, Alexander D.
Morgenstern, Isabelle H.
Horch, Raymund E.
Secondary “Hybrid Reconstruction“ Concept with Silicone Implants After Autologous Breast Reconstruction – Is It Safe and Reasonable?
title Secondary “Hybrid Reconstruction“ Concept with Silicone Implants After Autologous Breast Reconstruction – Is It Safe and Reasonable?
title_full Secondary “Hybrid Reconstruction“ Concept with Silicone Implants After Autologous Breast Reconstruction – Is It Safe and Reasonable?
title_fullStr Secondary “Hybrid Reconstruction“ Concept with Silicone Implants After Autologous Breast Reconstruction – Is It Safe and Reasonable?
title_full_unstemmed Secondary “Hybrid Reconstruction“ Concept with Silicone Implants After Autologous Breast Reconstruction – Is It Safe and Reasonable?
title_short Secondary “Hybrid Reconstruction“ Concept with Silicone Implants After Autologous Breast Reconstruction – Is It Safe and Reasonable?
title_sort secondary “hybrid reconstruction“ concept with silicone implants after autologous breast reconstruction – is it safe and reasonable?
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238811/
https://www.ncbi.nlm.nih.gov/pubmed/32388530
http://dx.doi.org/10.12659/MSM.921329
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