Two-Stage Reconstruction of Large and Ptotic Breasts in Patients Undergoing Risk-Reducing Mastectomy: A Single Center...

Area of Science:

• Plastic Surgery
• Oncologic Surgery
• Breast Reconstruction

Background:

• Large, ptotic breasts present unique challenges for risk-reducing mastectomy and reconstruction.
• A two-stage approach may offer benefits for selected patient populations.

Purpose of the Study:

• To report institutional experience with a two-stage breast reconstruction for large, ptotic breasts.
• To evaluate the safety and efficacy of this approach in risk-reducing mastectomy patients.

Main Methods:

• Retrospective analysis of patients undergoing two-stage breast reconstruction (August 2019 - September 2023).
• Inclusion criteria: large, ptotic breasts; exclusion criteria: prior cosmetic reduction, loss to follow-up.
• Data collected: demographics, operative details (Wise-pattern reduction, mastectomy, autologous flaps), outcomes.

Main Results:

• Five of 61 (8.19%) patients underwent the two-stage approach.
• Mean age 41.6 years, BMI 29.16 kg/m2.
• Flap types included deep inferior epigastric artery perforator and L-shaped upper gracilis (LUG) flaps.
• 100% flap survival rate with minimal complications.
• Average tissue excised: ~500g right, ~560g left breast.

Conclusions:

• The two-stage Wise-pattern reduction followed by mastectomy and autologous reconstruction is an effective method for large, ptotic breasts.
• This approach demonstrates high flap survival and low complication rates.
• Further comparative studies are recommended to optimize timing and techniques.