Dual-Plane Prosthetic Reconstruction Using the Modified Wise Pattern Mastectomy and Fasciocutaneous Flap in Women with Macromastia
- 1 September 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Plastic and Reconstructive Surgery
- Vol. 126 (3), 731-738
- https://doi.org/10.1097/prs.0b013e3181e3b38a
Abstract
Skin-sparing mastectomy and immediate breast reconstruction in women with macromastia is often difficult. The Wise pattern skin-reducing mastectomy often provides the best options for shape and symmetry, but is not without morbidity. The authors reviewed their experience with a modified Wise pattern mastectomy and tissue expander reconstruction to improve safety. All patients with breast cancer who underwent a skin-sparing mastectomy and modified Wise pattern skin-reducing reconstruction with a tissue expander were included. A dual-plane technique was used by covering the expander with the pectoralis muscle and a vascularized lower pole fasciocutaneous flap. Patient demographics were queried and outcomes were assessed. Twenty-seven patients (34 breasts) underwent tissue expander reconstruction using the dual-plane vascularized coverage technique. The average body mass index was 34 (range, 24 to 42). The average contralateral reduction weight was 502 g on all 20 unilateral reconstructions. Postoperative complications occurred in 37 percent of the patients (10 of 27), with seroma being the most common [six of 34 reconstructions (18 percent)]. The unplanned reoperation rate was 15 percent. The average follow-up was 16 months (range, 2 months to 4.5 years). The authors have demonstrated that modifications to the Wise pattern mastectomy with a tissue expander using a dual plane of vascularized tissue coverage can optimize results in patients with breast cancer and macromastia. Complications still occur, but they can usually be treated conservatively.Keywords
This publication has 11 references indexed in Scilit:
- Wise-Pattern Breast ReconstructionAnnals of Plastic Surgery, 2009
- Refinements of the LeJour vertical mammaplasty skin pattern for skin-sparing mastectomy and immediate breast reconstructionJournal of Plastic, Reconstructive & Aesthetic Surgery, 2007
- Nonexpansive Immediate Breast Reconstruction Using Human Acellular Tissue Matrix Graft (AlloDerm)Annals of Plastic Surgery, 2006
- Implant Breast Reconstruction Using Acellular Dermal MatrixAnnals of Plastic Surgery, 2006
- Immediate Bilateral Breast Reconstruction With Implants and Inferolateral AlloDerm SlingsAnnals of Plastic Surgery, 2005
- Complete One-Stage, Immediate Breast Reconstruction with Prosthetic Material in Patients with Large or Ptotic BreastsPlastic and Reconstructive Surgery, 2002
- Use of a Skin-Sparing Reduction Pattern to Create a Combination Skin-Muscle Flap Pocket in Immediate Breast ReconstructionPlastic and Reconstructive Surgery, 2002
- Outcome Comparison between Free and Pedicled TRAM Flap Breast Reconstruction in the Obese PatientPlastic and Reconstructive Surgery, 2001
- Effect of Obesity on Flap and Donor-Site Complications in Free Transverse Rectus Abdominis Myocutaneous Flap Breast ReconstructionPlastic and Reconstructive Surgery, 2000
- Modified Skin Incisions for MastectomyPlastic and Reconstructive Surgery, 1991