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One-Stage Immediate Breast Reconstruction: A Concise Review.
Bertozzi, Nicolò; Pesce, Marianna; Santi, Pierluigi; Raposio, Edoardo.
Afiliación
  • Bertozzi N; Department of Medicine and Surgery, Plastic Surgery Division, University of Parma, Parma, Italy.
  • Pesce M; Cutaneous, Mini-Invasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy.
  • Santi P; Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
  • Raposio E; Plastic Surgery Department, IRCCS San Martino University Hospital, National Institute for Cancer Research Genoa, Genoa, Italy.
Biomed Res Int ; 2017: 6486859, 2017.
Article en En | MEDLINE | ID: mdl-29098159
ABSTRACT

BACKGROUND:

One-stage direct-to-implant immediate breast reconstruction (IBR) is performed simultaneously with breast cancer resection. We explored indications, techniques, and outcomes of IBR to determine its feasibility, safety, and effectiveness. MATERIAL AND

METHODS:

We reviewed the available literature on one-stage direct-to-implant IBR, with or without acellular dermal matrix (ADM), synthetic mesh, or autologous fat grafting. We analyzed the indications, preoperative work-up, surgical technique, postoperative care, outcomes, and complications.

RESULTS:

IBR is indicated for small-to-medium nonptotic breasts and contraindicated in patients who require or have undergone radiotherapy, due to unacceptably high complications rates. Only patients with thick, well-vascularized mastectomy flaps are IBR candidates. Expandable implants should be used for ptotic breasts, while anatomical shaped implants should be used to reconstruct small-to-medium nonptotic breasts. ADMs can be used to cover the implant during IBR and avoid muscle elevation, thereby minimizing postoperative pain. Flap necrosis, reoperation, and implant loss are more common with IBR than conventional two-staged reconstruction, but IBR has advantages such as lack of secondary surgery, faster recovery, and better quality of life.

CONCLUSIONS:

IBR has good outcomes and patient-satisfaction rates. With ADM use, a shift from conventional reconstruction to IBR has occurred. Drawbacks of IBR can be overcome by careful patient selection.
Asunto(s)

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Mama / Neoplasias de la Mama / Mamoplastia / Implantes de Mama Límite: Female / Humans Idioma: En Año: 2017 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Mama / Neoplasias de la Mama / Mamoplastia / Implantes de Mama Límite: Female / Humans Idioma: En Año: 2017 Tipo del documento: Article