Posters
Academic Level (Author 1)
Medical Student
Discipline Track
Clinical Science
Abstract
Background: Mastectomy scar appearance impacts patients’ perception of themselves following breast reconstruction. If a peri-elliptical approach for skin-sparing mastectomy is used the resultant mastectomy scar lies transversely across the center of the breast mound, causing patient dissatisfaction and emotional stress. The authors describe a surgical technique to avoid the presence of mastectomy scars across the breast mound by progressively lowering the mastectomy scar until it lies in a discrete position under the breast in patients undergoing implant-based reconstruction.
Methods: The authors first describe the operative technique in detail. A retrospective chart review of 26 patients from 2017-2022 who underwent the operation was then performed to demonstrate the efficacy of the procedure. Data collected includes co-morbid conditions, smoking status, type of cancer, timing of reconstruction, placement of expander in relation to the pectoralis muscle, number of surgeries needed to reach the inframammary fold, complications, length of follow up, and patient reported satisfaction.
Results: A total of 26 patients were identified who underwent alloplastic breast reconstruction using an expander after SSM. Of these patients, the mean age was 51.6 with extremes of 32 years old and 74 years old, 15% had a history of smoking, 53% were clinically obese, and 15% had a history of Diabetes mellitus. Most patients (38%) received a diagnosis of Ductal Carcinoma in Situ or Invasive Ductal Carcinoma (53%); 65% underwent pre-operative chemotherapy, and 30% underwent pre-operative radiation as part of their oncologic treatment. Of these patients, 73% had bilateral reconstruction with 96% having pre-pectoral tissue expander placement. No patient needed more than 2 surgeries to transposition of the mastectomy scar onto the IMF. While 6 patients underwent scar revision after the second surgery, there are 5 patients with medical photo follow up times of over a year after the second surgery who all persisted to have appropriate scar placement without migration.
Conclusions: The operative technique described improves breast cosmesis without greater number of surgeries as compared to standard implant-based techniques with the use of expanders and produces high patient satisfaction with minimal complications or need for scar revision.
Presentation Type
Poster
Recommended Citation
Podsednik Gardner, Allison; Lopez, Annalisa; Nunez, Aidee; and De La Garza, Mauricio, "A New Technique: Transposition of Transverse Breast Mound Mastectomy Scars to the Inframammary Fold" (2024). Research Colloquium. 25.
https://scholarworks.utrgv.edu/colloquium/2023/posters/25
Included in
A New Technique: Transposition of Transverse Breast Mound Mastectomy Scars to the Inframammary Fold
Background: Mastectomy scar appearance impacts patients’ perception of themselves following breast reconstruction. If a peri-elliptical approach for skin-sparing mastectomy is used the resultant mastectomy scar lies transversely across the center of the breast mound, causing patient dissatisfaction and emotional stress. The authors describe a surgical technique to avoid the presence of mastectomy scars across the breast mound by progressively lowering the mastectomy scar until it lies in a discrete position under the breast in patients undergoing implant-based reconstruction.
Methods: The authors first describe the operative technique in detail. A retrospective chart review of 26 patients from 2017-2022 who underwent the operation was then performed to demonstrate the efficacy of the procedure. Data collected includes co-morbid conditions, smoking status, type of cancer, timing of reconstruction, placement of expander in relation to the pectoralis muscle, number of surgeries needed to reach the inframammary fold, complications, length of follow up, and patient reported satisfaction.
Results: A total of 26 patients were identified who underwent alloplastic breast reconstruction using an expander after SSM. Of these patients, the mean age was 51.6 with extremes of 32 years old and 74 years old, 15% had a history of smoking, 53% were clinically obese, and 15% had a history of Diabetes mellitus. Most patients (38%) received a diagnosis of Ductal Carcinoma in Situ or Invasive Ductal Carcinoma (53%); 65% underwent pre-operative chemotherapy, and 30% underwent pre-operative radiation as part of their oncologic treatment. Of these patients, 73% had bilateral reconstruction with 96% having pre-pectoral tissue expander placement. No patient needed more than 2 surgeries to transposition of the mastectomy scar onto the IMF. While 6 patients underwent scar revision after the second surgery, there are 5 patients with medical photo follow up times of over a year after the second surgery who all persisted to have appropriate scar placement without migration.
Conclusions: The operative technique described improves breast cosmesis without greater number of surgeries as compared to standard implant-based techniques with the use of expanders and produces high patient satisfaction with minimal complications or need for scar revision.