Management of contralateral breast following mastectomy and breast reconstruction using a mirror adjustment with crescent mastopexy technique

• Published in: Breast cancer (Tokyo, Japan) Japan), 2018, Vol.25 (1), p.94-99
• Main Authors: Cogliandro, A., Brunetti, B., Barone, Mauro, Favia, G., Persichetti, P.
• Format: Article
• Language: English
• Subjects: Breast Implants; Breast Neoplasms - surgery; Cancer Research; Comparative analysis; Cross-Sectional Studies; Disease Management; Esthetics; Female; Follow-Up Studies; Humans; Mammaplasty; Mastectomy; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Methods; Middle Aged; Oncology; Original Article; Patient satisfaction; Patient Satisfaction - statistics & numerical data; Prognosis; Retrospective Studies; Surgeons; Surgery; Surgical Oncology
• ISSN: 1340-6868; 1880-4233
• DOI: 10.1007/s12282-017-0796-6

Introduction Heterologous breast reconstruction after mastectomy sometimes requires the management of the contralateral breast to achieve symmetric long lasting aesthetic results. Some techniques could be used for the symmetrization of contralateral breast with or without implants as breast augmentation, reduction mammoplasty, mastopexy, with T inverted, J, vertical, periareolar, semi-circular, or axillary scars. The aim of this study is to present the use of crescent mastopexy technique with implants in contralateral adjustment following monolateral breast reconstruction compared with a control group in which patients underwent other contralateral procedures. We used BREAST-Q to evaluate breast perception and patient’s satisfaction and surgeon-rated aesthetic outcomes were measured using the Kroll evaluation (a global and itemized aesthetic tool). Materials and methods A retrospective study was designed. We enrolled in the study 55 patients who had undergone breast reconstruction with implants and contralateral breast symmetrization procedure at our hospital between 2010 and 2016, and they answered to BREAST-Q postoperative module after almost 1 year from breast reconstruction. The study population consisted of 2 groups of women: patient underwent contralateral adjustment with crescent mastopexy and augmentation and patients underwent other contralateral procedures. Statistical analysis was performed using descriptive and summary statistics to identify a central tendency between the two groups, we applied Fisher’s exact test to the results to obtain answers 1 year after the last procedure for the two groups. Results This cross-sectional study compared two cohorts in which 55 women underwent monolateral mastectomy and breast reconstruction with contralateral adjustment, 15 of these underwent contralateral crescent mastopexy with augmentation, and 40 (control group) underwent contralateral breast adjustment with other mastopexy and augmentation technique (27 patients underwent T inverted mastopexy, 2 J mastopexy, 6 vertical scar mastopexy, 5 periareolar mastopexy). Nineteen patients suffered of co-morbidities (smoking, autoimmune disease, cardiological, neurological, and dismetabolic). All patients answered the postoperative BREAST-Q reconstruction module almost 1 year from last surgical procedure. Conclusions In patients with a pseudoptosis or mild ptosis of the contralateral breast, crescent mastopexy could be a valid procedure with minimal scars, better