Visual Perception of Breast Free Flap Size Is Influenced by Radiation Changes of Surrounding Tissue.


Journal

Journal of reconstructive microsurgery
ISSN: 1098-8947
Titre abrégé: J Reconstr Microsurg
Pays: United States
ID NLM: 8502670

Informations de publication

Date de publication:
12 Apr 2023
Historique:
pubmed: 18 3 2023
medline: 18 3 2023
entrez: 17 3 2023
Statut: aheadofprint

Résumé

 Microsurgical reconstruction for bilateral mastectomy defects after unilateral radiation often results in asymmetry, despite both flap tissues never being radiated.  Photos of 16 patients who received prior radiation to one breast and underwent bilateral abdominal free flap reconstruction were taken postoperatively. Layperson and expert assessment were attained via online crowdsourcing and a panel of attending surgeons and senior residents. Stratification by interflap weight differences was done for subanalysis.  A total of 399 laypersons responded, with the majority (57.3%) reporting that the radiated breast appeared smaller than the nonradiated breast. When the photos were stratified by interflap weight differences, the photos with the radiated side flap weight over 3% more than nonradiated side were significantly more likely to be perceived by laypersons as the same size (odds ratio [OR] = 2.7;  Higher aesthetic scores were noted when larger flaps were inset to the radiated envelope by both laypersons and experts, suggesting potential technical refinement in reconstructive outcomes.

Sections du résumé

BACKGROUND BACKGROUND
 Microsurgical reconstruction for bilateral mastectomy defects after unilateral radiation often results in asymmetry, despite both flap tissues never being radiated.
METHODS METHODS
 Photos of 16 patients who received prior radiation to one breast and underwent bilateral abdominal free flap reconstruction were taken postoperatively. Layperson and expert assessment were attained via online crowdsourcing and a panel of attending surgeons and senior residents. Stratification by interflap weight differences was done for subanalysis.
RESULTS RESULTS
 A total of 399 laypersons responded, with the majority (57.3%) reporting that the radiated breast appeared smaller than the nonradiated breast. When the photos were stratified by interflap weight differences, the photos with the radiated side flap weight over 3% more than nonradiated side were significantly more likely to be perceived by laypersons as the same size (odds ratio [OR] = 2.7;
CONCLUSION CONCLUSIONS
 Higher aesthetic scores were noted when larger flaps were inset to the radiated envelope by both laypersons and experts, suggesting potential technical refinement in reconstructive outcomes.

Identifiants

pubmed: 36928906
doi: 10.1055/a-2056-1991
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Yi-Hsueh Lu (YH)

Division of Plastic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Fei Wang (F)

Division of Plastic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Evan Rothchild (E)

Division of Plastic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Nicolas Greige (N)

Division of Plastic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Karan Mehta (K)

Division of Plastic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Katie E Weichman (KE)

Division of Plastic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Joseph A Ricci (JA)

Division of Plastic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.

Classifications MeSH