Becker Expander-Based Breast Reconstruction Following Wise Pattern Skin-Reducing Mastectomy: Complication Rates and...

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncoplastic Surgery

Background:

• Macromastia presents unique challenges for breast reconstruction.
• Skin-reducing mastectomy (SRM) is a technique used in breast reduction and reconstruction.
• Immediate breast reconstruction aims to restore breast aesthetics and symmetry post-mastectomy.

Purpose of the Study:

• To analyze outcomes of immediate breast reconstruction in macromastia patients following skin-reducing mastectomy (SRM).
• To identify complications and risk factors associated with this reconstructive approach.
• To evaluate the efficacy of an inverted-T SRM with a myodermal flap for expander coverage.

Main Methods:

• A cohort of 50 women with macromastia underwent immediate expander-based breast reconstruction after Wise pattern SRM between 2008-2013.
• An inferiorly based de-epithelialized skin flap created a myodermal pouch to cover Becker-35 expanders.
• Complications and risk factors (BMI, smoking, radiotherapy, chemotherapy, expander size) were recorded and analyzed over up to 60 months follow-up.

Main Results:

• Overall complication rate was 27.6% (18/65 breasts), including skin ischemia (16.9%), infection (3%), seroma (6.1%), expander rotation (1.5%), and capsular contracture (7.6%).
• Complications were significantly associated with preoperative radiotherapy and smoking.
• No significant correlation was found between complications and chemotherapy, BMI, age, or expander size.

Conclusions:

• Immediate inverted-T SRM with a myodermal flap offers a viable single-stage reconstructive option for macromastia patients.
• Preoperative radiotherapy is a significant risk factor for increased postoperative complications and potentially suboptimal outcomes.
• This technique provides safe coverage and support for expanders in immediate breast reconstruction.