J Korean Soc Plast Reconstr Surg.  2007 Sep;34(5):622-627.

Immediate Breast Reconstruction Placing the Breast Implant under the Pectoralis Major-Serratus Anterior Pocket without Tissue Expansion

Affiliations
  • 1Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. tjlee@amc.seoul.kr
  • 2Department of General Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.

Abstract

PURPOSE: Although the autogenous tissue transfer has been the mainstay of the breast reconstruction, concern for the donor site morbidity can lead to the superseded method using tissue expander with implant or permanent expander-implant. However, the additional procedure of tissue expansion possibly cause discomfort and raise the cost. We tried to verify the efficacy of using the saline-filled breast implant by itself for the safe and convenient immediate breast reconstruction modality if the patients have small, round and non-ptotic breasts and the sufficient breast skin can be saved with mastectomy.
METHODS
From July 2002 to July 2005, 29 breasts of 26 patients were restored only with the saline-filled breast implant immediately after the skin sparing or nipple-areolar skin sparing mastectomy in Asan Medical Center. A pocket with pectoralis major and serratus anterior muscle was created and the implant was covered with this muscle pocket. Simultaneous contralateral augmentation was performed in patients whose mastectomy specimen weighed less than 100g.
RESULTS
Using only the saline-filled breast implant resulted in the successful reconstruction with few complications including partial necrosis of nipple areolar skin (five cases, 17.2%), capsular contracture (three cases, 10.3%), hematoma (one case, 3.4%), depigmentation of areolar skin (one case, 3.4%), hypertrophic scar (one case, 3.4%), which were all healed by conservative management. There were no significant complications such as implant exposure and subsequent removal.
CONCLUSION
Immediate breast reconstruction only with the saline-filled breast implant can be a satisfactory alternative option for the patients whose breast is small, round and non-ptotic, especially when the nipple-areolar skin of the breast is preserved in the mastectomy.

Keyword

Gynecomastia; Subcutaneous mastectomy

MeSH Terms

Breast Implants*
Breast*
Chungcheongnam-do
Cicatrix, Hypertrophic
Contracture
Female
Gynecomastia
Hematoma
Humans
Male
Mammaplasty*
Mastectomy
Mastectomy, Subcutaneous
Necrosis
Nipples
Skin
Tissue Donors
Tissue Expansion Devices
Tissue Expansion*
Full Text Links
  • JKSPRS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr