ADM assisted Immediate Breast Reconstruction with a vertical incision and horizontal dermal flap.
Association of Breast Surgery ePoster Library. Powell-Brett S. 05/15/17; 166328; P138
Ms. Sarah Powell-Brett
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Abstract
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There are several areas of contention with the use of acellular dermal matrix (ADM) including scar placement; this has traditionally been horizontal, over the pectoralis to protect the implant and ADM. This can present an aesthetic challenge, producing a boxy shape with less natural projection in large and ptotic breasts. Our series uses a vertical incision with horizontal skin reduction and dermal flap to improve aesthetic outcome with minimal complications.
All patients who underwent immediate implant-based, subpectoral, ADM assisted, single stage breast reconstruction following a vertical incision skin sparing mastectomy with a horizontal dermal flap between June 2014 and January 2016 were included. Data collected prospectively included demographics, adjuvant therapy and post-operative complications. A single, oncoplastic trained consultant performed all operations.
24 patients (30 breasts) were identified; average age 47, Mean BMI 25.2, cup size range C to F. Four significant post-operative complications arose, one implant loss, one seroma requiring drainage, one case of C-diff and one case of prolonged erythema and blistering along the wound line (possible infection).
Results NMBRA outcome NMBRA target
Infection 6.7% 25% <10%
Implant loss 3.3% 25% <10%
In our series we believe we have a practical, reproducible, single-stage method that has excellent outcomes with minimal complications and improved cosmetic result. We therefore recommend the vertical incision with horizontal skin reduction and dermal flap as a valuable addition to reconstructive techniques, especially in larger and more ptotic breasts.
All patients who underwent immediate implant-based, subpectoral, ADM assisted, single stage breast reconstruction following a vertical incision skin sparing mastectomy with a horizontal dermal flap between June 2014 and January 2016 were included. Data collected prospectively included demographics, adjuvant therapy and post-operative complications. A single, oncoplastic trained consultant performed all operations.
24 patients (30 breasts) were identified; average age 47, Mean BMI 25.2, cup size range C to F. Four significant post-operative complications arose, one implant loss, one seroma requiring drainage, one case of C-diff and one case of prolonged erythema and blistering along the wound line (possible infection).
Results NMBRA outcome NMBRA target
Infection 6.7% 25% <10%
Implant loss 3.3% 25% <10%
In our series we believe we have a practical, reproducible, single-stage method that has excellent outcomes with minimal complications and improved cosmetic result. We therefore recommend the vertical incision with horizontal skin reduction and dermal flap as a valuable addition to reconstructive techniques, especially in larger and more ptotic breasts.
There are several areas of contention with the use of acellular dermal matrix (ADM) including scar placement; this has traditionally been horizontal, over the pectoralis to protect the implant and ADM. This can present an aesthetic challenge, producing a boxy shape with less natural projection in large and ptotic breasts. Our series uses a vertical incision with horizontal skin reduction and dermal flap to improve aesthetic outcome with minimal complications.
All patients who underwent immediate implant-based, subpectoral, ADM assisted, single stage breast reconstruction following a vertical incision skin sparing mastectomy with a horizontal dermal flap between June 2014 and January 2016 were included. Data collected prospectively included demographics, adjuvant therapy and post-operative complications. A single, oncoplastic trained consultant performed all operations.
24 patients (30 breasts) were identified; average age 47, Mean BMI 25.2, cup size range C to F. Four significant post-operative complications arose, one implant loss, one seroma requiring drainage, one case of C-diff and one case of prolonged erythema and blistering along the wound line (possible infection).
Results NMBRA outcome NMBRA target
Infection 6.7% 25% <10%
Implant loss 3.3% 25% <10%
In our series we believe we have a practical, reproducible, single-stage method that has excellent outcomes with minimal complications and improved cosmetic result. We therefore recommend the vertical incision with horizontal skin reduction and dermal flap as a valuable addition to reconstructive techniques, especially in larger and more ptotic breasts.
All patients who underwent immediate implant-based, subpectoral, ADM assisted, single stage breast reconstruction following a vertical incision skin sparing mastectomy with a horizontal dermal flap between June 2014 and January 2016 were included. Data collected prospectively included demographics, adjuvant therapy and post-operative complications. A single, oncoplastic trained consultant performed all operations.
24 patients (30 breasts) were identified; average age 47, Mean BMI 25.2, cup size range C to F. Four significant post-operative complications arose, one implant loss, one seroma requiring drainage, one case of C-diff and one case of prolonged erythema and blistering along the wound line (possible infection).
Results NMBRA outcome NMBRA target
Infection 6.7% 25% <10%
Implant loss 3.3% 25% <10%
In our series we believe we have a practical, reproducible, single-stage method that has excellent outcomes with minimal complications and improved cosmetic result. We therefore recommend the vertical incision with horizontal skin reduction and dermal flap as a valuable addition to reconstructive techniques, especially in larger and more ptotic breasts.
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