Changes in Skin Paddle Morphology after Autologous Breast Reconstruction

Immediate autologous breast reconstruction (IABR) can provide favorable aesthetic outcomes after skin-sparing mastectomy. However, it is known that the morphology of the reconstructed breast changes over time. Therefore, it is necessary to be able to predict the likely amount of change preoperatively to reconstruct a symmetrical breast. In this study, we retrospectively examined the change in position and morphology of the skin paddle of the reconstructed breast over time.

Thirty-five patients who underwent IABR after skin-sparing mastectomy for unilateral breast cancer were included. Three-dimensional images were obtained at 1 month and 12 months postoperatively to compare changes in the position and size of the skin paddle over time.

Significant increases were observed in the distance between the center of the skin paddle and the midpoint of the clavicle, the distance between the center of the skin paddle and the sternal notch, and projection. No significant change was observed in the distance between the inframammary fold and the center of the skin paddle. There was a significant increase in the area and short axis of the skin paddle.

Our main findings were that the skin paddle shifts toward the outer caudal side after IABR and tends to become larger. When planning delayed nipple reconstruction with a local flap designed on a skin paddle, the paddle should be positioned slightly more mediocranially than the healthy nipple and should be narrower.