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Case Reports
. 2018 Nov 13;6(11):e1976.
doi: 10.1097/GOX.0000000000001976. eCollection 2018 Nov.

Breast-sharing Technique in a Unilateral Mastectomy Patient

Daan Geerards  1   2 , Alexander J Kroeze  1   2 , Vincent J Kroeze  2 , Coralien L Broekhuysen  1
Affiliations
Case Reports

Breast-sharing Technique in a Unilateral Mastectomy Patient

Daan Geerards et al. Plast Reconstr Surg Glob Open. .

Abstract

Breast reconstruction patients frequently desire consecutive or simultaneous contralateral breast reduction. When combining the requirements of both autologous breast reconstruction with symmetrizing breast reduction, a 2-staged contralateral pedicled breast sharing is a dignified alternative. We present a 60-year-old woman with a radical mastectomy and adjuvant radiotherapy. On the contralateral side, she had a hypertrophic breast with a desire for reduction mammaplasty. A 2-stage procedure for breast sharing was planned. A preoperative computed tomography scan, to assess the status of the fourth intercostal mammary perforator (IMAP), was performed. After the first procedure, symmastia was evident. Water-assisted liposuction and quilting sutures to the sternal periosteum were applied in a second procedure to correct the symmastia. We preserved the fourth intercostal perforator to provide optimal vascularization. Water-assisted liposuction and quilting sutures were used to correct the remaining symmastia and contributed to the aesthetics of both breasts. A drawback of this procedure is the need for multiple stages. Furthermore, oncological safety should be considered and surgeons should be aware of the risk for venous congestion. Breast-sharing could be a feasible alternative reconstruction for women seeking unilateral breast reconstruction with contralateral breast hypertrophy. It reduces the need for free-flap surgery and subsequent donor-site morbidity. Considering the fact that the contralateral breast must be of significant size, the indication for this type of reconstruction is limited.

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Figures

Fig. 1.
Fig. 1.
Preoperative markings for breast sharing after right mastectomy.
Fig. 2.
Fig. 2.
Graphical display of first stage breast sharing reconstruction (1) preoperative marking; (2) split over breast-meridian; (3) localization of fourth IMAP; (4) flap transposition; (5) postoperative scar.
Fig. 3.
Fig. 3.
Postoperative result after first stage of the breast sharing reconstruction.
Fig. 4.
Fig. 4.
Final result of the multi-stage breast sharing reconstruction, frontal view.
Fig. 5.
Fig. 5.
Final result of the multi-stage breast sharing reconstruction, side view from the right.
Fig. 6.
Fig. 6.
Final result of the multi-stage breast sharing reconstruction, side view from the left.
See this image and copyright information in PMC

References

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