Dual-Layer Rotation: A Versatile Therapeutic Mammoplasty Technique

Area of Science:

• Oncoplastic surgery
• Breast cancer treatment
• Surgical reconstruction

Background:

• Multifocal or complex breast lesions pose challenges for breast-conserving surgery, especially in small breasts or upper inner quadrant locations.
• The dual-layer rotation (DLR) mammoplasty technique manipulates skin and glandular tissue in separate layers to fill resection cavities, enabling vertical mammoplasty without extensive skin excision.

Purpose of the Study:

• To evaluate the efficacy and outcomes of DLR mammoplasty for breast cancer.
• To assess reoperations, complications, adjuvant treatment delays, and aesthetic results of DLR mammoplasty.

Main Methods:

• Retrospective review of consecutive breast cancer patients undergoing DLR mammoplasty (2017-2019).
• Evaluation of clinical data, surgical outcomes, complications, and adjuvant treatment timelines.
• Objective and subjective assessment of aesthetic outcomes from patient photographs.

Main Results:

• 46 breasts from 40 patients were analyzed; tumors were in the upper inner quadrant (30%) or multiple quadrants (22%).
• 33% of patients had small breast cup sizes (A-B).
• Negative margins were achieved in 45/46 breasts; major complications occurred in 3 patients, with one adjuvant therapy delay. Two patients required late refinement surgery.

Conclusions:

• DLR mammoplasty is a novel oncoplastic approach for selected breast cancer patients with challenging resection defects.
• The technique provides a one-step solution, preserving the breast's natural appearance.
• It is effective for various breast sizes and lesion locations, yielding good aesthetic results.