Immediate breast reconstruction using autologous skin graft associated with breast implant

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2012-02, Vol.65 (2), p.187-194
• Main Authors: Dutra, A.K, Andrade, W.P, Carvalho, S.M.T, Makdissi, F.B.A, Yoshimatsu, E.K, Domingues, M.C, Maciel, M.S
• Format: Article
• Language: English
• Subjects: Adult; Autologous skin graft; Biological and medical sciences; Breast Implants; Female; Follow-Up Studies; Humans; Immediate breast reconstruction; Mammaplasty - methods; Mastectomy; Medical sciences; Middle Aged; Plastic Surgery; Retrospective Studies; Skin Transplantation - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Time Factors; Transplantation, Autologous; Treatment Outcome
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2011.09.010

Summary Background Immediate breast reconstruction with skin graft is still little mentioned in the literature. Follow-up studies regarding the technique aspects are particularly scarce. The objective was to detail immediate breast reconstruction using autologous skin graft. Methods Patients ( n   =  49) who underwent mastectomies and autologous immediate breast reconstruction with skin graft associated with a breast implant at A. C. Camargo Hospital (São Paulo, Brazil) between January 2007 and July 2010 were included. Information on clinical data, technique details and clinical outcome were prospectively collected. Following mastectomy, the autologous full-thickness skin graft was obtained through an inframammary fold incision along the contralateral breast in most patients. The skin graft was placed on the surface of the pectoralis major muscle after adjustments to conform to the mastectomy defect. A minimum of 10-month follow-up period was established. Results Patients’ age ranged from 35 to 55 years and all received a silicone gel textured surface implant to obtain the necessary breast mound. The mean surgical time was 45 min, and the mean amount of skin resection was 4.5 cm in the largest diameter. Follow-up ranged from 10 to 35 months (median 23). All patients had silicone-gel textured surface implants to perform the breast mound reconstruction. No complications were observed in 87.8% of reconstructions. Forty-six patients (94%) had no complaints about the donor-site aesthetics. The result was a breast mound with a central ellipse of healed skin graft. Three (6%) poor results were observed. Thirty-six patients (67%) reported the results as good or very good. Conclusions Our results lead us to conclude that autologous skin graft provided a reliable option in immediate breast reconstruction to skin-sparing mastectomy defects. The technique accomplished a single-stage implant breast reconstruction when there is inadequate skin coverage.