J Breast Cancer.  2010 Jun;13(2):147-153. 10.4048/jbc.2010.13.2.147.

Contralateral Breast Management Related to Breast Reconstruction in Korean Females

• Yang JD
• Lee JH
• Chung HY
• Cho BC
• Park HY
• Jung JH

• KMID: 2286539
• DOI: http://doi.org/10.4048/jbc.2010.13.2.147

Abstract

PURPOSE
The final purpose of post mastectomy reconstruction is a balanced, symmetrical, pleasing appearance for both breasts. However, in cases where women have an unattractive breast, which may be small, ptotic or huge, remodeling of the contralateral breast may be desirable. Surgical options available for the contralateral breast included breast augmentation using implants, mastopexy, and reduction mammoplasty.
METHODS
All patients who underwent unilateral breast reconstruction at Kyungpook National University Hospital from September of 2006 to February of 2008 were included in this study. The methods of reconstruction included transverse rectus abdominis musculocutaneous flap, latissimus dorsi flap, and the use of implants. Contralateral procedures to achieve symmetry included augmentation, mastopexy, and reduction.
RESULTS
A total of 57 patients were evaluated, including 45 immediate, and 12 delayed reconstructions. Twenty-six of these patients underwent contralateral breast management (augmentation [12], mastopexy [11], and reduction [3]). The average age was 44.9 years and the mean follow up interval was 13 months. Most of the patients were satisfied with the symmetry, clothed appearance, nude appearance, aesthetics, and consistency. Sixty-six percent (8 of 12) of delayed reconstruction patients had a symmetry procedure performed on the opposite breast, compared with 40 percent (18 of 45) of the immediate-reconstruction patients. No complications were observed on the contralateral breasts undergoing symmetrization.
CONCLUSION
Contralateral management in breast reconstruction can provide symmetry with the reconstructed breast contour and aesthetically satisfactory results in a safe manner. Immediate symmetrization procedure also can avoid secondary operations and offer psychological benefits without delaying adjuvant therapy.

Keyword

Breast neoplasms; Breast reconstruction; Contralateral breast

MeSH Terms

Breast
Breast Neoplasms
Esthetics
Female
Follow-Up Studies
Humans
Mammaplasty
Mastectomy
Rectus Abdominis

Figure

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  Figure 1 A vertical mastopexy for ptotic breast. (A) After deepithelization. (B) Pillars pulled together with inverted sutures. (C) Immediate postoperative view. (D) When both correction of ptosis and projection were needed, the inferior thoracic-based flap of the breast was transposed underneath and fixed to the pectoralis fascia for added projection.

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  Figure 2 Satisfaction rate. The subjective analysis of results by patients indicated satisfaction with the combined procedure. Contralateral procedure group (A). Ipsilateral breast reconstruction only group (B).

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  Figure 3 (A, B) A 36-year-old woman with cancer of the left breast. (C, D) The same patient after skin sparing mastectomy. Immediate TRAM flap reconstruction and augmentation on contralateral breast were performed. Results 12 months postoperatively.

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  Figure 4 (A, B) A 36-year-old woman with cancer of the right breast. (C, D) The same patient after skin sparing mastectomy. Immediate breast reconstruction with a silicone implant and periareolar mastopexy on the contralateral breast were performed. Results 14 months postoperatively.

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  Figure 5 (A, B) A 47-year-old woman with cancer of the left breast. (C, D) The same patient after delayed TRAM flap reconstruction and vertical reduction on the contralateral breast. Results 13 months postoperatively.

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