Technical considerations in nonreconstructive mastectomy patients.
breast reconstruction
flat reconstruction
mastectomy
Journal
The breast journal
ISSN: 1524-4741
Titre abrégé: Breast J
Pays: United States
ID NLM: 9505539
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
22
07
2019
revised:
24
08
2019
accepted:
06
09
2019
pubmed:
4
10
2019
medline:
22
6
2021
entrez:
4
10
2019
Statut:
ppublish
Résumé
Not all women undergo post-mastectomy breast reconstruction due to medical comorbidities or personal preference. An aesthetically pleasing closure and contour of the chest wall is still desired, though may be technically difficult to achieve in some patients. By combining techniques and lessons learned from breast reductions and female-to-male mastectomies (FTTM), we present a technical approach to aesthetic primary closure post-mastectomy that can be utilized in patients regardless of preoperative breast size. After mastectomy, excess cranial/caudal tissue is determined and the lower flap is de-epithelialized to allow for bulk in the reconstructed breast. Excess tissue in the horizontal plane is assessed, and axillary, nonbreast tissue is medialized. Excess skin in the horizontal plane is removed with a small lateral incision similar to a wise-pattern closure. We have performed this technique with good aesthetic results and satisfied patients postoperatively. When performing post-mastectomy closure without reconstruction, attention to tissue excess, medialization of axillary tissue and providing bulk with lateral and caudal tissue allows for an easy, reproducible, and aesthetic closure.
Sections du résumé
BACKGROUND
Not all women undergo post-mastectomy breast reconstruction due to medical comorbidities or personal preference. An aesthetically pleasing closure and contour of the chest wall is still desired, though may be technically difficult to achieve in some patients. By combining techniques and lessons learned from breast reductions and female-to-male mastectomies (FTTM), we present a technical approach to aesthetic primary closure post-mastectomy that can be utilized in patients regardless of preoperative breast size.
METHODS
After mastectomy, excess cranial/caudal tissue is determined and the lower flap is de-epithelialized to allow for bulk in the reconstructed breast. Excess tissue in the horizontal plane is assessed, and axillary, nonbreast tissue is medialized. Excess skin in the horizontal plane is removed with a small lateral incision similar to a wise-pattern closure.
RESULTS
We have performed this technique with good aesthetic results and satisfied patients postoperatively.
CONCLUSION
When performing post-mastectomy closure without reconstruction, attention to tissue excess, medialization of axillary tissue and providing bulk with lateral and caudal tissue allows for an easy, reproducible, and aesthetic closure.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
702-704Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
Molinari, and Susan. “H.R.616-105th Congress (1997-1998): women's health and cancer rights Act of 1997.” Congress.gov, 3 Mar. 1997, www.congress.gov/bill/105th-congress/house-bill/616
Flat & Fabulous. Flat & Fabulous. www.flatandfabulous.org/