“Medial wing Hemi-mastopexy”: An innovation to avoid medial pole emptiness in reduction mammaplasty
Association of Breast Surgery ePoster Library. Garreffa E. 05/13/19; 257197; P155
Mr. Emanuele Garreffa
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P155
Topic: Surgical techniques
Introduction: In heavier breasts, there is a greater lower outer parenchymal distraction resulting in relative emptiness medially. The default excision of the horizontal-V medial wing parenchyma in wise-pattern or vertical mammaplasty may either maintain or worsen this emptiness. We present a technical innovation to avoid such loss of volume. Methods :Mammaplasty markings are as standard/practiced. However, instead of being excised, the medial wing is de-epithelised, inverted, and the horizontal limbs of the V sutured along de-epithelised edges. A retrospective analysis of single-surgeon(AA) cases in prospectively maintained database was performed. Results: Of the 15 patients (23 breasts) with a mean age of 48.01(43-79) years and BMI of 33.6(19.7-43.6), 16 underwent Therapeutic mammaplasty (TM) in cancer and 7 symmetrizing reductions. Mean reduction/excision weight, length of stay and follow-up were 188.57(36-598) g., 1.2(0-2) days and 20(2-40)months respectively. 2(8.7%) mammaplasty had wound related problems: one nipple sinus with fat necrosis (TM in smoker) and other T-junction minor dehiscence with cellulitis. There were no re-admission or re-operation within 30 days. Conclusions: This technical innovation has no increased direct technique-related complications including following radiotherapy compared to UK national TM (TeAM) audit (23.3% overall complications, 1.4% re-admission and 2.8% returned to theatre within 30 days). In addition, it retains the dermal vascularity along the medial half of the wound. Although, this will not be applicable in lower inner quadrant tumours in TM, it could be applied to other quadrant tumours as well as in cosmetic setting
Topic: Surgical techniques
Introduction: In heavier breasts, there is a greater lower outer parenchymal distraction resulting in relative emptiness medially. The default excision of the horizontal-V medial wing parenchyma in wise-pattern or vertical mammaplasty may either maintain or worsen this emptiness. We present a technical innovation to avoid such loss of volume. Methods :Mammaplasty markings are as standard/practiced. However, instead of being excised, the medial wing is de-epithelised, inverted, and the horizontal limbs of the V sutured along de-epithelised edges. A retrospective analysis of single-surgeon(AA) cases in prospectively maintained database was performed. Results: Of the 15 patients (23 breasts) with a mean age of 48.01(43-79) years and BMI of 33.6(19.7-43.6), 16 underwent Therapeutic mammaplasty (TM) in cancer and 7 symmetrizing reductions. Mean reduction/excision weight, length of stay and follow-up were 188.57(36-598) g., 1.2(0-2) days and 20(2-40)months respectively. 2(8.7%) mammaplasty had wound related problems: one nipple sinus with fat necrosis (TM in smoker) and other T-junction minor dehiscence with cellulitis. There were no re-admission or re-operation within 30 days. Conclusions: This technical innovation has no increased direct technique-related complications including following radiotherapy compared to UK national TM (TeAM) audit (23.3% overall complications, 1.4% re-admission and 2.8% returned to theatre within 30 days). In addition, it retains the dermal vascularity along the medial half of the wound. Although, this will not be applicable in lower inner quadrant tumours in TM, it could be applied to other quadrant tumours as well as in cosmetic setting
P155
Topic: Surgical techniques
Introduction: In heavier breasts, there is a greater lower outer parenchymal distraction resulting in relative emptiness medially. The default excision of the horizontal-V medial wing parenchyma in wise-pattern or vertical mammaplasty may either maintain or worsen this emptiness. We present a technical innovation to avoid such loss of volume. Methods :Mammaplasty markings are as standard/practiced. However, instead of being excised, the medial wing is de-epithelised, inverted, and the horizontal limbs of the V sutured along de-epithelised edges. A retrospective analysis of single-surgeon(AA) cases in prospectively maintained database was performed. Results: Of the 15 patients (23 breasts) with a mean age of 48.01(43-79) years and BMI of 33.6(19.7-43.6), 16 underwent Therapeutic mammaplasty (TM) in cancer and 7 symmetrizing reductions. Mean reduction/excision weight, length of stay and follow-up were 188.57(36-598) g., 1.2(0-2) days and 20(2-40)months respectively. 2(8.7%) mammaplasty had wound related problems: one nipple sinus with fat necrosis (TM in smoker) and other T-junction minor dehiscence with cellulitis. There were no re-admission or re-operation within 30 days. Conclusions: This technical innovation has no increased direct technique-related complications including following radiotherapy compared to UK national TM (TeAM) audit (23.3% overall complications, 1.4% re-admission and 2.8% returned to theatre within 30 days). In addition, it retains the dermal vascularity along the medial half of the wound. Although, this will not be applicable in lower inner quadrant tumours in TM, it could be applied to other quadrant tumours as well as in cosmetic setting
Topic: Surgical techniques
Introduction: In heavier breasts, there is a greater lower outer parenchymal distraction resulting in relative emptiness medially. The default excision of the horizontal-V medial wing parenchyma in wise-pattern or vertical mammaplasty may either maintain or worsen this emptiness. We present a technical innovation to avoid such loss of volume. Methods :Mammaplasty markings are as standard/practiced. However, instead of being excised, the medial wing is de-epithelised, inverted, and the horizontal limbs of the V sutured along de-epithelised edges. A retrospective analysis of single-surgeon(AA) cases in prospectively maintained database was performed. Results: Of the 15 patients (23 breasts) with a mean age of 48.01(43-79) years and BMI of 33.6(19.7-43.6), 16 underwent Therapeutic mammaplasty (TM) in cancer and 7 symmetrizing reductions. Mean reduction/excision weight, length of stay and follow-up were 188.57(36-598) g., 1.2(0-2) days and 20(2-40)months respectively. 2(8.7%) mammaplasty had wound related problems: one nipple sinus with fat necrosis (TM in smoker) and other T-junction minor dehiscence with cellulitis. There were no re-admission or re-operation within 30 days. Conclusions: This technical innovation has no increased direct technique-related complications including following radiotherapy compared to UK national TM (TeAM) audit (23.3% overall complications, 1.4% re-admission and 2.8% returned to theatre within 30 days). In addition, it retains the dermal vascularity along the medial half of the wound. Although, this will not be applicable in lower inner quadrant tumours in TM, it could be applied to other quadrant tumours as well as in cosmetic setting
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