RESUMEN
BACKGROUND: In the past, several publications have described breast reconstruction techniques that utilize the contralateral breast; however, interest diminished because of technical difficulty, scarring, and poor aesthetic results. OBJECTIVES: This study aimed to present a new breast reconstruction technique that uses a combination of the breast-pectoralis flap and the abdominal advancement flap. METHODS: This retrospective study analyzed the results and complications of 20 consecutive breast reconstructions with the breast-pectoralis flap technique. RESULTS: The authors present a series of 20 breast reconstructions that utilized the breast-pectoralis flap. Delayed breast reconstruction was performed in 13 cases (65%), breast reconstruction in 5 patients (25%) with Poland syndrome, sequela correction after a chest wall sarcoma in 1 patient (5%), and sequela correction after breast cystic lymphangioma resection in 1 patient (5%). One complication required surgical reintervention without long-term consequences. The outcomes were considered very good in 50% of the cases, good in 45%, and fair in 5%. CONCLUSIONS: The combination of the breast-pectoralis flap and the abdominal advancement flap is an interesting advance in breast reconstruction. Evaluation of the presented cases suggests wider indications for this technique.
Asunto(s)
Neoplasias de la Mama , Mamoplastia , Colgajos Quirúrgicos , Humanos , Femenino , Mamoplastia/métodos , Mamoplastia/efectos adversos , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Colgajos Quirúrgicos/trasplante , Colgajos Quirúrgicos/efectos adversos , Resultado del Tratamiento , Neoplasias de la Mama/cirugía , Músculos Pectorales/cirugía , Músculos Pectorales/trasplante , Síndrome de Poland/cirugía , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/epidemiología , Adulto Joven , Mastectomía/efectos adversos , Trasplante Autólogo/métodos , EstéticaRESUMEN
The treatment of sequelae after conservative breast cancer treatment can be a challenge. Lipomodeling, although controversial in the beginning, is a safe technique that can help in the treatment of these deformities, without an important impact on the imaging surveillance. Depending on the severity of the deformity, one or several sessions of fat transfer can be required. The technique is easy and reproducible, but before obtaining satisfying results with a low complication rate, a learning curve should be completed. The final result is natural, with normal breast consistency, with no additional scars.
Asunto(s)
Tejido Adiposo/trasplante , Mamoplastia/métodos , Neoplasias de la Mama/cirugía , Cicatriz/prevención & control , Femenino , Humanos , Mamoplastia/efectos adversos , Mastectomía Segmentaria , Selección de PacienteRESUMEN
Complete breast reconstruction with fat grafting is an appealing technique because it does not add scars or use flaps, is autologous, and has the secondary benefit of liposuction. It is a multiple stage surgery and usually requires balancing of the contralateral breast. After using this technique since 2001, the authors narrowed the indications, the ideal candidate being a patient with small breasts and enough donor sites for up to 4 or 5 lipomodeling sessions. Breast reconstruction with fat grafting alone in total breast reconstruction has very limited indications, because lipomodeling in combination with other autologous reconstruction gives very nice results.