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Mastectomy Incision Design to Optimize Aesthetic Outcomes in Breast Reconstruction

BACKGROUND: Choosing the optimal mastectomy incision must account for oncologic, reconstructive, and aesthetic considerations, including nipple preservation, mastectomy skin margins and potential for skin involvement, mastectomy skin perfusion and viability, mastectomy skin excess, previous breast s...

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Autores principales: Lotan, Adi Maisel, Tongson, Krystina C., Police, Alice M., Dec, Wojciech
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544272/
https://www.ncbi.nlm.nih.gov/pubmed/33133941
http://dx.doi.org/10.1097/GOX.0000000000003086
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author Lotan, Adi Maisel
Tongson, Krystina C.
Police, Alice M.
Dec, Wojciech
author_facet Lotan, Adi Maisel
Tongson, Krystina C.
Police, Alice M.
Dec, Wojciech
author_sort Lotan, Adi Maisel
collection PubMed
description BACKGROUND: Choosing the optimal mastectomy incision must account for oncologic, reconstructive, and aesthetic considerations, including nipple preservation, mastectomy skin margins and potential for skin involvement, mastectomy skin perfusion and viability, mastectomy skin excess, previous breast scars, the reconstructive plan, and inconspicuous new scar placement. In the present study, we aimed to assess breast reconstruction aesthetics, as they are influenced by mastectomy incision design. METHODS: Nine commonly utilized mastectomy incision patterns were grouped into 3 categories: hidden scar, vertical scar, and transverse scar. Twenty plastic surgeons were asked to blindly grade before and after photographs of reconstructed breasts with regard to scar visibility and position and according to their influence on breast aesthetics. RESULTS: Statistically significant differences were observed between the study groups. Mastectomies and reconstructions performed through hidden incisions yield the most aesthetic results. Vertical scars are favorable to transverse scars. In the case of bilateral reconstructions, symmetric scar placement is paramount to optimizing aesthetic outcomes. CONCLUSIONS: The mastectomy incision pattern significantly affects the aesthetic outcomes in breast reconstruction. Patterns borrowed from cosmetic breast surgery consistently yield highly aesthetic outcomes. Surgeons must consider oncologic factors and patient characteristics in choosing an ideal incision for each patient.
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spelling pubmed-75442722020-10-29 Mastectomy Incision Design to Optimize Aesthetic Outcomes in Breast Reconstruction Lotan, Adi Maisel Tongson, Krystina C. Police, Alice M. Dec, Wojciech Plast Reconstr Surg Glob Open Breast BACKGROUND: Choosing the optimal mastectomy incision must account for oncologic, reconstructive, and aesthetic considerations, including nipple preservation, mastectomy skin margins and potential for skin involvement, mastectomy skin perfusion and viability, mastectomy skin excess, previous breast scars, the reconstructive plan, and inconspicuous new scar placement. In the present study, we aimed to assess breast reconstruction aesthetics, as they are influenced by mastectomy incision design. METHODS: Nine commonly utilized mastectomy incision patterns were grouped into 3 categories: hidden scar, vertical scar, and transverse scar. Twenty plastic surgeons were asked to blindly grade before and after photographs of reconstructed breasts with regard to scar visibility and position and according to their influence on breast aesthetics. RESULTS: Statistically significant differences were observed between the study groups. Mastectomies and reconstructions performed through hidden incisions yield the most aesthetic results. Vertical scars are favorable to transverse scars. In the case of bilateral reconstructions, symmetric scar placement is paramount to optimizing aesthetic outcomes. CONCLUSIONS: The mastectomy incision pattern significantly affects the aesthetic outcomes in breast reconstruction. Patterns borrowed from cosmetic breast surgery consistently yield highly aesthetic outcomes. Surgeons must consider oncologic factors and patient characteristics in choosing an ideal incision for each patient. Lippincott Williams & Wilkins 2020-09-24 /pmc/articles/PMC7544272/ /pubmed/33133941 http://dx.doi.org/10.1097/GOX.0000000000003086 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 Breast
Lotan, Adi Maisel
Tongson, Krystina C.
Police, Alice M.
Dec, Wojciech
Mastectomy Incision Design to Optimize Aesthetic Outcomes in Breast Reconstruction
title Mastectomy Incision Design to Optimize Aesthetic Outcomes in Breast Reconstruction
title_full Mastectomy Incision Design to Optimize Aesthetic Outcomes in Breast Reconstruction
title_fullStr Mastectomy Incision Design to Optimize Aesthetic Outcomes in Breast Reconstruction
title_full_unstemmed Mastectomy Incision Design to Optimize Aesthetic Outcomes in Breast Reconstruction
title_short Mastectomy Incision Design to Optimize Aesthetic Outcomes in Breast Reconstruction
title_sort mastectomy incision design to optimize aesthetic outcomes in breast reconstruction
topic Breast
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544272/
https://www.ncbi.nlm.nih.gov/pubmed/33133941
http://dx.doi.org/10.1097/GOX.0000000000003086
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