Changes in Skin Paddle Morphology after Autologous Breast Reconstruction

Area of Science:

• Plastic Surgery
• Breast Reconstruction
• Aesthetic Outcomes

Background:

• Immediate autologous breast reconstruction (IABR) offers aesthetic benefits post-mastectomy.
• Reconstructed breast morphology changes over time, impacting symmetry.
• Predicting these changes preoperatively is crucial for optimal outcomes.

Purpose of the Study:

• To retrospectively analyze changes in skin paddle position and morphology after IABR.
• To provide data for predicting long-term aesthetic results and planning further reconstruction.
• To improve symmetry in breasts reconstructed with IABR.

Main Methods:

• Retrospective analysis of 35 patients undergoing IABR post-skin-sparing mastectomy.
• Acquisition of 3D images at 1 and 12 months post-operation.
• Comparison of skin paddle position (distance from clavicle, sternal notch) and size (projection, area, short axis).

Main Results:

• Significant increase in the distance of the skin paddle center from the clavicle and sternal notch.
• Significant increase in skin paddle projection, area, and short axis.
• No significant change in the distance between the inframammary fold and the skin paddle center.

Conclusions:

• The skin paddle in IABR demonstrates a significant shift towards the outer caudal aspect and an increase in size over 12 months.
• This positional and morphological change should be considered during surgical planning.
• For delayed nipple reconstruction, positioning the flap slightly more mediocranially and narrower than the contralateral side is recommended.