Evolving options for breast reconstruction

Caterson, Stephanie A.; Carty, Matthew J.; Helliwell, Lydia A.; Hergrueter, Charles A.; Pribaz, Julian J.; Sinha, Indranil

doi:10.1067/j.cpsurg.2015.04.001

Cited by 11 publications

(7 citation statements)

References 104 publications

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“…The surgical techniques employed did not change during the study period and have been previously described elsewhere. 7 , 12 In DIEP procedures, a standardized preoperative computed tomography angiography (CTA) assessment has been started in early 2008, and SPY intraoperative laser angiography has been intermittently used since 2012.…”

Section: Methodsmentioning

confidence: 99%

Bilateral Free Flap Breast Reconstruction Outcomes: Do Abdominal Scars Affect Bilateral Flaps?

Unukovych

Caterson

Carty

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Section: Methodsmentioning

confidence: 99%

Bilateral Free Flap Breast Reconstruction Outcomes: Do Abdominal Scars Affect Bilateral Flaps?

Unukovych

Caterson

Carty

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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“…SGA and IGA perforator flaps are widely used in autologous breast reconstruction since present large and versatile volume of hairless soft tissue (Caterson et al, 2015). Moreover, this type of flap preserves the integrity and function of the gluteal muscles (Georgantopoulou et al, 2014).…”

Section: R Esu L Tsmentioning

confidence: 99%

Radiological anatomy of the perforators of the gluteal region: The “radiosome” based anatomy

Vigato

Tiengo

et al. 2017

Microsurgery

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Background The superior (SGA) and the inferior gluteal artery (IGA) perforator flaps are widely used in pressure‐sore repair and in breast reconstruction. The aim was to exhaustively depict the topographical anatomy of the whole system of perforators in the buttock. Methods Eighty lower‐extremity computed tomographic angiography (CTA) of patients (20 males/20 females, mean age 61‐years old, range 38‐81) were considered. The source artery, location, type, and caliber of gluteal perforators were analyzed. The location of perforators was reproduced using a standardized two‐dimensional grid on the coronal plane, centered onto defined bone landmarks. We defined “radiosome” the cutaneous vascular territory of a source artery inferred through the representation of its whole perforator system at the exit point through the deep fascia. Results A mean number of 25.6 ± 5.7 perforators in the gluteal region was observed, distributed as follows: 11.6 ± 4.8(45.2%) from SGA; 7.9 ± 4.5(30.8%) from IGA; 1.5 ± 0.8(5.8%) from fifth lumbar artery; 1.2 ± 0.8(4.7%) from internal pudendal artery; 1.2 ± 1(4.8%) from lateral circumflex femoral artery; 0.3 ± 0.7(1.2%) from circumflex iliac superficial artery. At least one large (internal diameter > 1 mm) SGA septocutaneous perforator was present in 77.5% of patients. Conclusions The gluteal region is vascularized by perforators of multiple source arteries. Septocutaneous perforators of SGA and IGA were planned along a curve drawn from the posterior‐superior border of the iliac crest to the greater trochanter. The lumbar artery perforators are clustered over the apex of the iliac crest; the internal pudendal artery perforators are clustered medially to the ischiatic tuberosity. Contributions can also come from the sacral and superficial circumflex iliac arteries.

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“…Implant‐based reconstruction continues to account for the majority of reconstructive procedures performed in Australia, the UK and the USA 8 . This can be performed in an immediate or delayed setting.…”

Section: Introductionmentioning

confidence: 99%

Immediate prepectoral implant reconstruction using TiLOOP Bra Pocket results in improved patient satisfaction over dual plane reconstruction

Quah

Graham

et al. 2021

ANZ Journal of Surgery

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Background Implant‐based reconstruction accounts for the majority of breast reconstructive procedures performed in Australia. More recently, immediate prepectoral implant reconstruction using the TiLOOP Bra Pocket has gained popularity. This study compares post‐surgical complications and patient‐reported quality of life outcomes between immediate prepectoral and dual plane implant reconstruction. Methods A retrospective study of 80 consecutive patients who underwent nipple‐sparing mastectomies and immediate implant reconstruction was conducted. Implants were either completely covered with TiLOOP Bra and/or TiLOOP Bra Pocket (pfm medical, Cologne, Germany) and secured in the prepectoral space (prepectoral group) or placed in the subpectoral plane with inferolateral mesh coverage (dual plane group). Data surrounding patient demographics, clinical details and post‐surgical outcomes were compared. Patient‐related quality of life outcomes were assessed with the Breast‐Q questionnaire. Results A total of 80 patients (109 breasts) operated on between June 2016 and December 2018 were included. The prepectoral and dual plane groups comprised of 40 patients each, including 50 and 59 operated breasts, respectively. Post‐operative complications were comparable with 11 (22%) overall complications in the prepectoral group and eight (14%) in the dual plane group (P = 0.313). Implant loss was uncommon with four (8%) cases in the prepectoral group and five (8.5%) in the dual plane group (P = 0.929). Patient‐reported quality of life outcomes were superior after prepectoral reconstruction with patients reporting a significantly higher score in the satisfaction with breasts domain (68.9 versus 57.5; P = 0.036). Conclusion Immediate prepectoral implant reconstruction with the TiLOOP Bra Pocket was associated with improved patient satisfaction and demonstrated no difference in early post‐operative outcomes.

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Evolving options for breast reconstruction

Cited by 11 publications

References 104 publications

Bilateral Free Flap Breast Reconstruction Outcomes: Do Abdominal Scars Affect Bilateral Flaps?

Bilateral Free Flap Breast Reconstruction Outcomes: Do Abdominal Scars Affect Bilateral Flaps?

Radiological anatomy of the perforators of the gluteal region: The “radiosome” based anatomy

Immediate prepectoral implant reconstruction using TiLOOP Bra Pocket results in improved patient satisfaction over dual plane reconstruction

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