by Rose, Jessica F.; Doval, Andres F.; Zavlin, Dmitry;
Ellsworth, Warren A.; Echo, Anthony; Spiegel, Aldona J
Plastic and
Reconstructive Surgery: June 2021 -
Volume 147 - Issue 6 - p 1271-1277
Background:
Autologous free flap breast reconstruction is a common
reconstructive procedure, with the ability to produce a natural breast shape
and a long history of success. Despite its benefits, there are special
situations in which patients lack sufficient donor-site tissue to achieve
adequate breast size and projection. With this study, the authors describe
their institutional experience of delayed implant augmentation after autologous
breast reconstruction with a particular focus on pedicle division as a
technique to improve aesthetic results.
Methods:
A retrospective chart review of patients that underwent free
flap autologous breast reconstruction with delayed implant augmentation was
conducted over a 13-year period. Flaps were divided into a control group
without pedicle division and a divided pedicle group. Groups were compared in
terms of demographics, clinical and surgical characteristics, implant details,
and postoperative implant and flap complications.
Results:
No significant differences in terms of age, body mass index,
comorbidities, radiation therapy, or surgical indications were noted. The most
common reason for delayed implant augmentation after autologous breast
reconstruction was change in breast size and breast asymmetry. In terms of
implant and flap complications, we found no significant differences between the
control and divided pedicle groups after delayed implant augmentation.
Conclusions:
From the authors’ institutional experience, pedicle division
in delayed breast augmentation with implants after free flap breast reconstruction
can be safety performed in selected cases. This technique can be a powerful
tool for plastic surgeons to improve the final aesthetic appearance of the
reconstructed breast.
CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
