Breast Reconstruction make use of Contralateral Breast Tissue after Mastectomy

유방절제술 후 반대편 유방조직을 이용하여 유방 재건한 증례

  • Lee, Dong-Gwan (Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine) ;
  • Seul, Jung-Hyun (Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine) ;
  • Lim, Young Bin (Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine) ;
  • Shin, Hea-Kyeong (Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine) ;
  • Choi, Jun (Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine)
  • 이동관 (동국대학교 경주병원 의과대학 성형외과학교실) ;
  • 설정현 (동국대학교 경주병원 의과대학 성형외과학교실) ;
  • 임영빈 (동국대학교 경주병원 의과대학 성형외과학교실) ;
  • 신혜경 (동국대학교 경주병원 의과대학 성형외과학교실) ;
  • 최준 (동국대학교 경주병원 의과대학 성형외과학교실)
  • Published : 2009.07.15

Abstract

Purpose: Unilateral breast reconstruction after mastectomy confront the challenges of recreating a natural appearing breast mound and achieving symmetricalness of the breasts. If the patient's remaining breast is large compared to reconstructed breast, the most common procedure is reduction mammoplasty of the large breast side. The authors experienced a new method of breast reconstruction using the excess breast tissue from the contralateral breast after breast reduction. Methods: The excess tissue from the contralateral breast after vertical reduction mammoplasty with superior pedicle and remaining lower breast tissue were transferred to the mastectomy site breast through the subcutaneous tunnel on the chest wall. The main blood supplies of the flap are perforator branches of the 4th, 5th and 6th anterior intercostal artery. After elevating and detaching the flap on the lower lateral area of the breast, the turn overed flap is fixed on the upper portion of the chest wall of the mastectomy site. Results: On two cases of the breast reconstructions, remaining excess breast tissue from reduction mammoplasty was transferred to the contralateral breast side as pedicles. Both patient and operator were satisfied with the outcome of the reconstruction as the breasts were symmetrical and natural shape. Conclusion: We have performed unilateral breast reconstruction using the excess breast tissue after reduction mammoplasty of the contralateral breast. As Oriental women's breasts are relatively smaller than that of Caucasian women, delayed breast reconstruction cases of Oriental women with large breasts(macromastia) seem to be ideal for this procedure.

References

  1. Losken A, Carlson GW, Bostwick J 3rd, Jones GE, Culbertson JH, Schoemann M: Trends in unilateral breast reconstruction and mamagement of the contralateral breast: the emory experience. Plast Reconstr Surg 110: 89, 2002 https://doi.org/10.1097/00006534-200207000-00016
  2. Munhoz AM, Montag E, Arruda E, Pellarin L, Filassi JR, de Barros AC, Prado LC, Fonseca A, Baracat E, Ferreira MC: Assessment of immediate conservative breast surgery reconstruction: a classification system of defects revisited and an algorithm for selecting the appropriate technique. Plast Reconstr Surg 121: 716, 2008 https://doi.org/10.1097/01.prs.0000299295.74100.fa
  3. Lejour M: Vertical mammaplasty and liposuction of the breast. Plast Reconstr Surg 94: 100, 1994 https://doi.org/10.1097/00006534-199407000-00010
  4. Shin HJ, Kim YH, Woo SH, Jeong JH, Seul JH: Vertical reduction mammaplasty. J Korean Soc Plast Reconstr Surg 24: 380, 1997
  5. Courtiss EH, Goldwyn RM: Reduction mammaplasty by the inferior pedicle technique. an alternative to free nipple and areola grafting for severe: Plast Reconstr Surg 59: 500, 1977
  6. Robbins TH: A reduction mammaplasty with the areola- nipple based on an inferior dermal pedicle. Plast Reconstr Surg 59: 64, 1977 https://doi.org/10.1097/00006534-197701000-00011
  7. Deventer PV, Page BJ, Graewe FR: The safety of pedicle in breast and mastopexy procedures. Aesthetic Plast Surg 32: 307, 2008 https://doi.org/10.1007/s00266-007-9070-1
  8. Marshall DR: The controlateral breast flap in reconstruction of the breast and chest wall. Ann Plast Surg 31: 508, 1993 https://doi.org/10.1097/00000637-199312000-00006
  9. Dian D, Drinovac V, Mylonas I, Friese K: Worldwide first successful splitting of the breast for a single-procedure reconstruction after mastectomy with maintaining the sensitivity. Arch Gynecol Obstet 04 Feb, 2009 https://doi.org/10.1007/s00404-009-0954-y