Breast Shape Evaluation After Free Flap Breast Reconstruction After More Than 10 Years Follow-up Using 3-Dimensional...

Area of Science:

• Plastic Surgery
• Biomedical Engineering
• Medical Imaging

Background:

• Autologous tissue breast reconstruction is common, but long-term morphological changes are underreported.
• Few studies evaluate the long-term shape of breasts after autologous reconstruction.
• This study addresses the need for long-term morphological data in breast reconstruction.

Purpose of the Study:

• To evaluate the long-term morphological changes in breast shape after autologous tissue breast reconstruction.
• To assess the shape balance between reconstructed and contralateral breasts over a decade.
• To identify factors influencing long-term breast shape outcomes.

Main Methods:

• Utilized Vectra, a 3D imaging device, for morphological evaluation.
• Included 16 deep inferior epigastric perforator flap cases with >10 years follow-up.
• Measured breast width, sternal notch-to-nipple distance, nipple-to-inframammary fold distance, and breast volume, comparing reconstructed to native breasts.

Main Results:

• Long-term average ratios: breast width 0.99, sternal notch-to-nipple 0.98, nipple-to-inframammary fold 0.94, breast volume 1.13.
• No significant differences in shape balance were found between obese and nonobese groups.
• No significant differences were observed between patients <50 and >50 years old at primary surgery.

Conclusions:

• Autologous breast reconstruction demonstrates sustained shape balance between breasts over the long term.
• Despite expectations of worsening shape due to sagging, the study found shape symmetry was maintained.
• Revision surgeries in over half the cases represent a limitation to definitive long-term shape assessment.