Vertical Mastectomy Incision in Implant Breast Reconstruction After Skin Sparing Mastectomy

Dayıcıoğlu, Deniz; Tugertimur, Bugra; Zemina, Kristen; Dallarosa, Johnathan; Killebrew, Sequoya; Wilson, Augustine Reid; Atisha, Dunya; Khakpour, Nazanin

doi:10.1097/sap.0000000000000676

Cited by 12 publications

(3 citation statements)

References 23 publications

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“…ere are several different types of incisions used thus far in NSM. ese include the periareolar incision, radial incision, lateral incision, IMF incision, mastopexy incision, reduction incision, and previous scar incision [7][8][9]. At our institution, breast surgeons mainly use the periareolar incision, radial incision, and lateral incision.…”

Section: Discussionmentioning

confidence: 99%

“…However, even if NSM has become a standard procedure for total mastectomy, various methods are used for the incision, depending on the breast surgeon because there are currently no guidelines on the incision method in NSM. e incisions made in patients with NSM include the periareolar incision, radial incision, lateral incision, and the inframammary fold (IMF) incision, each with its own advantages and disadvantages [7][8][9]. Here, complications, such as wound dehiscence and mastectomy skin flap necrosis, are common around the incision site.…”

Section: Introductionmentioning

confidence: 99%

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Outcome Analysis Depending on the Different Types of Incision following Immediate Breast Reconstruction

et al. 2022

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Background. Immediate breast reconstruction following nipple-sparing mastectomy (NSM) is widely used for its cosmetic benefits. Due to the lack of guidelines, the types of incisions in NSM vary and which method is superior remains a debate. In this study, we hypothesized that the periareolar incision has a higher risk of complications, such as nipple-areolar complex (NAC) necrosis, than other incisions. Methods. A retrospective chart review was conducted and divided into three groups: the periareolar, radial, and lateral incision groups. The reconstruction method and complications of NAC necrosis, wound dehiscence, seroma, hematoma, infection, and reconstruction failure were investigated. Results. A total of 103 patients (periareolar incision (33%, n = 34), radial incision (39.8%, n = 41), and lateral incision (27.2%, n = 28)) who underwent NSM and immediate breast reconstruction from 2018 to 2020 were included. The reconstruction methods were direct-to-implant, DIEP flap, LD flap, and PAP flap, and there was all of which had no statistically significant difference between the groups regarding the reconstruction method ( p = 0.257 ). In terms of complications, there was no significant difference in NAC necrosis (29.4%, 19.5%, and 21.4%, in the periareolar, radial, and lateral groups, respectively; p = 0.578 ), wound dehiscence, seroma or hematoma, infection, and reconstruction failure. Conclusion. Breast reconstruction following NSM through periareolar incision does not increase the incidence of complications, including NAC necrosis. However, since only Asian patients with low BMI were included, if an appropriate patient group is selected for immediate reconstruction after NSM, reconstruction can be safely performed through the periareolar incision, and good cosmetic results can be obtained.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcome Analysis Depending on the Different Types of Incision following Immediate Breast Reconstruction

et al. 2022

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“…Several authors have discussed the importance of the mastectomy scar pattern on final breast outcome in both autologous and implant based breast reconstruction. 9 Tan et al described a classification system for different mastectomy incisions and skin paddle designs specific to the Asian patient population. 10 This classification consists of a "racquet handle" incision and a periareolar incision alone or with adjacent skin excision or distant skin paddle.…”

Section: Discussionmentioning

confidence: 99%

Autologous Breast Reconstruction Skin Paddle Designs: Classification and Aesthetic Outcomes

Pestana

Walker

2019

J Reconstr Microsurg Open

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Objective Present study was conducted to identify common mastectomy patterns and autologous skin paddle designs, to identify patient characteristics that influence these patterns, and assess aesthetic outcomes associated with each pattern. Methods Autologous breast reconstructions over 5 years were reviewed. Mastectomy type and resultant skin paddle were categorized into four mastectomy type/skin paddle design groups based on the amount of native “Skin Spared” after mastectomy and the resultant flap skin paddle designed. Groups were designated as skin-sparing mastectomy 1 (SS1)/large elliptical skin paddle, skin-sparing mastectomy 2 (SS2)/small elliptical skin paddle, skin-sparing mastectomy 3 (SS3)/areola skin paddle, and skin-sparing mastectomy 4 (nipple-sparing mastectomy, SS4)/no skin paddle. Surveys were performed to validate the classification system and critique aesthetic outcomes. Results A total of 89 autologous breast reconstructions were included. Radiotherapy was used in 45.6% of SS1 patients versus 29.2% in SS2 and 12.5% in SS3/SS4. Mean body mass index (BMI) was 30 in SS1/SS2 and 26 in SS3/SS4 mastectomy types (p = 0.045). Delayed reconstruction was performed in 96.5% SS1 versus 62.5% in SS2 and only 25% of SS3/SS4 (p < 0.0001). Physicians and Non-MD personnel correctly categorized 85.8 and 76.1% of skin paddle designs, respectively. Over 75% of those surveyed rated the reconstruction aesthetic outcome as “good-excellent” regardless of the pattern group. Conclusions Patients in SS1/SS2 groups had a higher incidence of radiotherapy, delayed reconstruction, and higher BMI compared with the SS3/SS4 groups. The classification system is recognizable and may provide improved patient education and communication between healthcare providers. All mastectomy type/skin paddle designs received high aesthetic ratings.

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Comment on ‘‘Hook Shape’’ Nipple-Sparing Mastectomy and Prepectoral Implant Reconstruction: Technique, Results and Outcomes from a Preliminary Case Series

Atiyeh

Emsieh

2022

Aesth Plast Surg

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Vertical Mastectomy Incision in Implant Breast Reconstruction After Skin Sparing Mastectomy

Abstract: The use of vertical incision does not increase complication rates; does not interfere with tumor margins; and can be applied to all age, BMI, breast weight, and breast implant volume groups.

Cited by 12 publications

References 23 publications

Outcome Analysis Depending on the Different Types of Incision following Immediate Breast Reconstruction

Outcome Analysis Depending on the Different Types of Incision following Immediate Breast Reconstruction

Autologous Breast Reconstruction Skin Paddle Designs: Classification and Aesthetic Outcomes

Comment on ‘‘Hook Shape’’ Nipple-Sparing Mastectomy and Prepectoral Implant Reconstruction: Technique, Results and Outcomes from a Preliminary Case Series

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