Dual plane breast implant reconstruction in large sized breasts: How to maximise the result following first stage total submuscular expansion
Introduction: Women who were good candidates for a skin reducing mastectomy, but were instead treated with a skin-sparing mastectomy and reconstruction with expanders, show discrepancy of volume and form between the healthy breast (voluminous and ptotic) and the expanded mastectomy envelope and musc...
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| Format: | Article |
| Language: | English |
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Elsevier
2018-03-01
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| Series: | JPRAS Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352587817300712 |
| _version_ | 1828965607854309376 |
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| author | Giuseppe Giudice Michele Maruccia Eleonora Nacchiero Rossella Elia Paolo Annoscia Michelangelo Vestita |
| author_facet | Giuseppe Giudice Michele Maruccia Eleonora Nacchiero Rossella Elia Paolo Annoscia Michelangelo Vestita |
| author_sort | Giuseppe Giudice |
| collection | DOAJ |
| description | Introduction: Women who were good candidates for a skin reducing mastectomy, but were instead treated with a skin-sparing mastectomy and reconstruction with expanders, show discrepancy of volume and form between the healthy breast (voluminous and ptotic) and the expanded mastectomy envelope and muscle, which has a smaller size as well as excessive amount of skin at the lower pole.
Methods: From January 2014 to March 2015, we recruited 18 women with breasts of medium to large volume and with moderate to severe ptosis, already treated at a different centre with a one-side mastectomy and reconstruction by means of an expander. These women were treated at our unit for the second reconstructive step with a dual plane technique and a contralateral reduction/mastopexy.
Results: The minimum duration of follow-up was 2 years (range 24–30 months). The average volume of the implants was 613 g. The reconstructive outcome at the final follow-up (at least 24 months) was judged by the specialist as excellent in 5 cases, very good in 10 cases and good in 3 cases. Breast Q average score was 87.08.
Discussion: The disinsertion of the expanded muscle dome and the use of a dual plane technique for the placement of the definitive implant provide a solution to the skin-volume mismatch problem. The subcutaneous placement of the implant at the level of the lower pole extends the excessive amount of skin and gives the reconstructed breast fullness and natural ptosis. Further validation of our results is needed. |
| first_indexed | 2024-12-14T11:14:06Z |
| format | Article |
| id | doaj.art-fdeb6fba76ce4bdd8a38e4236fd53a7f |
| institution | Directory Open Access Journal |
| issn | 2352-5878 |
| language | English |
| last_indexed | 2024-12-14T11:14:06Z |
| publishDate | 2018-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JPRAS Open |
| spelling | doaj.art-fdeb6fba76ce4bdd8a38e4236fd53a7f2022-12-21T23:04:08ZengElsevierJPRAS Open2352-58782018-03-0115C748010.1016/j.jpra.2017.11.003Dual plane breast implant reconstruction in large sized breasts: How to maximise the result following first stage total submuscular expansionGiuseppe GiudiceMichele MarucciaEleonora NacchieroRossella EliaPaolo AnnosciaMichelangelo VestitaIntroduction: Women who were good candidates for a skin reducing mastectomy, but were instead treated with a skin-sparing mastectomy and reconstruction with expanders, show discrepancy of volume and form between the healthy breast (voluminous and ptotic) and the expanded mastectomy envelope and muscle, which has a smaller size as well as excessive amount of skin at the lower pole. Methods: From January 2014 to March 2015, we recruited 18 women with breasts of medium to large volume and with moderate to severe ptosis, already treated at a different centre with a one-side mastectomy and reconstruction by means of an expander. These women were treated at our unit for the second reconstructive step with a dual plane technique and a contralateral reduction/mastopexy. Results: The minimum duration of follow-up was 2 years (range 24–30 months). The average volume of the implants was 613 g. The reconstructive outcome at the final follow-up (at least 24 months) was judged by the specialist as excellent in 5 cases, very good in 10 cases and good in 3 cases. Breast Q average score was 87.08. Discussion: The disinsertion of the expanded muscle dome and the use of a dual plane technique for the placement of the definitive implant provide a solution to the skin-volume mismatch problem. The subcutaneous placement of the implant at the level of the lower pole extends the excessive amount of skin and gives the reconstructed breast fullness and natural ptosis. Further validation of our results is needed.http://www.sciencedirect.com/science/article/pii/S2352587817300712BreastReconstructionDual planeTwo stagesExpanderVolume mismatch |
| spellingShingle | Giuseppe Giudice Michele Maruccia Eleonora Nacchiero Rossella Elia Paolo Annoscia Michelangelo Vestita Dual plane breast implant reconstruction in large sized breasts: How to maximise the result following first stage total submuscular expansion JPRAS Open Breast Reconstruction Dual plane Two stages Expander Volume mismatch |
| title | Dual plane breast implant reconstruction in large sized breasts: How to maximise the result following first stage total submuscular expansion |
| title_full | Dual plane breast implant reconstruction in large sized breasts: How to maximise the result following first stage total submuscular expansion |
| title_fullStr | Dual plane breast implant reconstruction in large sized breasts: How to maximise the result following first stage total submuscular expansion |
| title_full_unstemmed | Dual plane breast implant reconstruction in large sized breasts: How to maximise the result following first stage total submuscular expansion |
| title_short | Dual plane breast implant reconstruction in large sized breasts: How to maximise the result following first stage total submuscular expansion |
| title_sort | dual plane breast implant reconstruction in large sized breasts how to maximise the result following first stage total submuscular expansion |
| topic | Breast Reconstruction Dual plane Two stages Expander Volume mismatch |
| url | http://www.sciencedirect.com/science/article/pii/S2352587817300712 |
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