Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women
Aesthetic Design of Skin-Sparing Mastectomy Incisions for Immediate Autologous Tissue Breast Reconstruction in Asian Women
Blog Article
Background The advent of skin-sparing mastectomy has allowed for the reconstruction of the breast and nipple with improved cosmesis.However, the nipple-areolar complex (NAC) in Asian patients is more pigmented USB Type-C U Dock and scars easily.Therefore, commonly described incisions tend to result in poor aesthetic outcomes in Asian patients with breast cancer.Methods We describe an algorithmic approach to skin-sparing mastectomy incisions in Asian patients on the basis of the location of the biopsy scar and the tumor site and size.
Four incision types are described: peri-areolar, a peri-areolar incision with a second distant skin paddle, "racquet handle," and peri-areolar with adjacent skin excision.Results 281 immediate breast reconstructions were performed between May 2001 and February 2012 after skin-sparing mastectomy.The mastectomy incisions used included the peri-areolar design (n=124, 44%), peri-areolar design with a second distant skin paddle (n=39, 14%), "racquet handle" (n=21, 7.5%), and peri-areolar design with adjacent skin excision (n=42, 14%).
The traditional elliptical incision and other variants where the NAC outline was not preserved were performed in the remaining 55 patients.The average follow-up was 44.7 months during which there was 1 case of total flap loss and 7 cases of partial flap necrosis; all remaining flaps survived.24% of the patients (68/281) underwent subsequent nipple reconstruction.
Conclusions Our algorithm avoids breast incisions that are randomly placed or excessively long and prevents the unnecessary sacrifice of normal breast skin.This allows skin-sparing mastectomy and immediate breast reconstruction to be performed with a consistently achievable aesthetic result HMB in Asian women without neglecting oncological safety.