Aesthetic role of the surgically rebuilt inframammary fold for implant-based breast reconstruction after mastectomy

Bogetti, Paolo; Cravero, Luca; Spagnoli, Giada; Devalle, Luca; Boriani, Filippo; Bocchiotti, Maria Alessandra; Renditore, Stefania; Baglioni, Elisabetta

doi:10.1016/j.bjps.2005.11.046

Cited by 31 publications

(22 citation statements)

References 6 publications

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“…8 Farley et al, and Bogetti P also used interrupted absorbable subcuticular sutures for wound closure. 9,10 Considering all the above mentioned facts authors thought of interrupted absorbable subcuticular sutures where authors can have the benefits of interrupted nonabsorbable sutures and absorbable sutures secondly the same suture material used for subcutaneous sutures can be used for subcuticular sutures also; in our study authors used 3-0 polyglactin for subcutaneous as well as subcuticular suturing. Apart from cosmesis by this technique authors can avoid let opening of the whole wound for evacuation of haematoma or any collection.…”

Section: Mann-whitney U Testmentioning

confidence: 74%

Absorbable versus conventional methods for wound closures in surgeries for benign breast diseases: a randomized case control study

Gopinathan

Ulahannan

2020

Int Surg J

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Background: Surgeons and patients prefer absorbable sutures for surgical wound closure in breast surgeries which are usually continuous subcuticular sutures so that patients can skip a hospital visit for suture removal. But in case of breast biopsies authors usually put circumareolar incisions. Here authors find it difficult to put continuous subcuticular sutures. In this contest authors thought of interrupted subcuticular sutures where authors can tackle the above-mentioned limitations; while actually reducing the financial burden of the patients.Methods: In this randomized case controlled study authors included elective general surgical procedures for benign breast diseases that was being carried out in the department of General Surgery Govt. Medical College, Kottayam for a period of 6 months starting from January 2017. Total number of cases taken are 20; 10 each in each group.Results: The mean rank for interrupted method was 14.20 and conventional method was 6.80. Mann-Whitney U statistic was 13.000 and p value was 0.03. Since p value was less than 0.05, authors had clear evidence to reject the null hypothesis. Therefore, authors concluded that both the methods were dissimilar and based on mean rank interrupted method seemed to be better method.Conclusions: Authors recommended interrupted absorbable subcuticular suturing technique in general surgical procedures for benign breast diseases, especially where authors used circumareolar incisions, which saved time of the surgeon and the patient. This can lead to considerable cost savings for the government without compromising clinical effectiveness or safety.

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Section: Mann-whitney U Testmentioning

confidence: 74%

Absorbable versus conventional methods for wound closures in surgeries for benign breast diseases: a randomized case control study

Gopinathan

Ulahannan

2020

Int Surg J

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“…Considering the recent trend towards implant-based reconstruction, non-autologus reconstruction provides several challenges to achieve good cosmetic results [5,6]. Aesthetic results are based on the essential features of a natural breast, including size, projection, upper pole contouring, lower pole fullness, ptosis, fold location, and symmetry [2,3,7]. Attaining superior cosmesis bears impact, as post-reconstruction analysis has linked patients' aesthetic scores and symmetry with patient satisfaction [7].…”

Section: Discussionmentioning

confidence: 99%

“…With increased patient awareness, expectations after breast reconstruction have increased manifold and assimilated towards that of the post-augmentation breast. The mainstay of breast reconstruction continues to be two stage tissue expander/implant (TE/I) based reconstructions, with aesthetic results hinging upon the creation of a natural breast shape with upper pole fullness, lower pole ptosis, and a well-defined inframammary fold (IMF) [2,3]. However, many surgeons fail to adequately address second stage procedures or the reconstruction process overall that can help achieve improved cosmesis [2,3].…”

Section: Introductionmentioning

confidence: 99%

Current Advances for Aesthetic Improvement in Breast Reconstruction: Mimicking the Augmented Breast

Rodby¹,

Quinn²,

Mehrara³

et al. 2014

Surgery Curr Res

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Background: Women seeking implant-based breast reconstruction increasingly request a round, projecting breast with an amplified upper pole that mimics the augmented breast. Two-stage reconstruction provides the opportunity to recreate a well-defined inframammary fold (IMF) with ptosis, to modify final implant characteristics (volume upsizing, high profile, gel implants) and correct contour irregularities with lipofilling at exchange to achieve this desired outcome. Methods/Technique: All patients completing two-stage breast reconstruction were added prospectively into a database. Patient demographics, oncologic phenotype and treatment, surgical details including IMF reconstruction, implant characteristics, and outcomes were reviewed. 2D and 3D photos and intraoperative videography were captured, further illustrating the technique. Results: 84 two-stage breast reconstructions were completed in 50 women between 5/2010-11/2013. Mean age at the time of mastectomy was 42.8 years and mean BMI was 30. At the time of exchange, the majority of implants were typically upsized from the final expansion volume, with a volume increase ranging from 10-150cc (mean increase 46cc). Mean expander fill volume and final implant volume were 595cc and 618cc respectively. Fifty-nine reconstructions (70%) included inframammary fold reinforcement. Sixty-eight (81%) of reconstructions utilized high profile or extra-high profile implants. Selective use of fat grafting was implemented later in the series. Conclusion: Current advances in two-stage implant based breast reconstruction are outlined to achieve upper pole fullness, anterior projection of the breast, and definition of the inframammary fold. These strategies afford reconstructive outcomes that parallel the desired aesthetic features of the augmented breast.

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“…Aesthetic outcomes of the overall reconstruction were scored on a ten-point scale, with 10 representing the best possible aesthetic outcome. Aesthetic outcome of the inframammary fold was graded on a four-point scale based on established scoring categories [17]. The fold was rated excellent if it was well-defined and symmetrical (score of 4), good if it was well-defined and asymmetrical (score of 3), and fair or poor if it was ill-defined (score of 2 or 1).…”

Section: Methodsmentioning

confidence: 99%

The Effect of Acellular Dermal Matrix in Implant-Based Immediate Breast Reconstruction with Latissimus Dorsi Flap.

Park

Shin

et al. 2017

Arch Aesthetic Plast Surg

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Aesthetic role of the surgically rebuilt inframammary fold for implant-based breast reconstruction after mastectomy

Cited by 31 publications

References 6 publications

Absorbable versus conventional methods for wound closures in surgeries for benign breast diseases: a randomized case control study

Absorbable versus conventional methods for wound closures in surgeries for benign breast diseases: a randomized case control study

Current Advances for Aesthetic Improvement in Breast Reconstruction: Mimicking the Augmented Breast

The Effect of Acellular Dermal Matrix in Implant-Based Immediate Breast Reconstruction with Latissimus Dorsi Flap.

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