Invited Response on: “Reverse Expansion and Tissue-Engineering for Breast Reconstruction”

Lucattelli, Elena; Cattin, Federico; Cipriani, Federico; Dellachiesa, Laura; Fogacci, Tommaso; Frisoni, Gianluca; Samorani, Domenico; Semprini, Gloria; Fabiocchi, Luca

doi:10.1007/s00266-022-02847-1

Cited by 2 publications

(1 citation statement)

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“…The reverse expansion procedure for breast reconstruction has already been described by our group, first in a small series of patients, 3 and later in a larger series after NSM. [4][5][6] The aim of this article is to describe our technique evolution, to clarify the advantages and disadvantages of the procedure by following a consecutive series of 100 patients over a period of 8 years, and to show the outcomes that may be expected.…”

Section: Introductionmentioning

confidence: 99%

Reverse Expansion for Breast Reconstruction after Skin-sparing and Nipple-sparing Mastectomy: Our First 100 Cases

Fabiocchi

Lucattelli

Cattin

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Patients with breast cancer have experienced advancements both in oncological treatment and in aesthetics as a result of developments in reconstructive techniques. We aimed to present our experience with the reverse expansion technique, summarizing the results of our first 100 cases of reconstruction after skin-sparing mastectomy and nipple-sparing mastectomy. Methods: From January 2010 to September 2018, 253 breast reconstruction procedures were performed on 100 patients. The reverse expansion technique consists of autologous fat tissue transplantation requiring the combined use of a skin expander and of multiple lipofilling sessions. At the beginning of every session the breast expander was deflated by removing a saline volume similar to that of the fat to be injected. Results: Overall, 56 breast reconstructions after skin-sparing mastectomy and 44 after nipple-sparing mastectomy were performed. An average of 661.5 cm 3 of fat per session was harvested and an average of 305.3 cm 3 per breast was injected. The average number of sessions to achieve breast reconstruction was 2.53. Only four complications after 253 procedures (1.5%) were reported: one donor site hemorrhage due to genetic lack of coagulation factors, and three surgical site infections. Conclusions: Considering the large number of positive factors such as a fast postoperative recovery, an easy learning curve, a lack of need of a specialized surgical team, a natural look of the breast shape, and the soft consistency of the grafted tissue, we believe this technique could be the first choice for autologous reconstruction after skin-sparing mastectomy and nipple-sparing mastectomy.

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