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Postburn breast reconstruction: a scoping review.

Eduardo Gus1,2, Jane Zhu3, Stephanie G Brooks3

  • 1Division of Plastic, Reconstructive & Aesthetic Surgery, The Hospital for Sick Children, Toronto, Canada.

Scars, Burns & Healing
|September 25, 2023
PubMed
Summary

This review maps literature on managing postburn breast deformities and reconstruction. Optimal timing and scar management are crucial for restoring symmetry and function, especially when burns occur before puberty.

Keywords:
Burnamastiabreastcontracturereconstructionscar

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Area of Science:

  • Plastic Surgery
  • Burn Reconstruction
  • Aesthetic Medicine

Background:

  • Postburn breast deformities present significant functional and aesthetic challenges.
  • Injuries before puberty can severely hinder normal breast development.
  • Reconstruction aims to restore native anatomy and symmetry.

Purpose of the Study:

  • To review and map the literature on scar management and breast reconstruction for postburn deformities.
  • To highlight specific strategies for thermally injured breasts.
  • To establish optimal timing principles for reconstructive procedures.

Main Methods:

  • Comprehensive literature search across MEDLINE and EMBASE databases, including grey literature.
  • Inclusion of studies of all designs discussing postburn breast deformity treatment.
  • 64 studies were included in this scoping review.

Main Results:

  • The most common study designs were case series (58%) and retrospective cohorts (28%).
  • Scar contracture release with split-thickness skin grafts (26%) was a frequent procedure.
  • Nipple-areola reconstruction techniques were utilized in 22% of cases.

Conclusions:

  • Scar contracture release is indicated early for restricted breast development.
  • Postmastectomy reconstruction techniques are necessary for amastia or hypoplastic breasts.
  • No standardized guideline exists; surgeons must adapt techniques to individual patient needs and timing.