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Simultaneous Contralateral Breast Reduction/Mastopexy With Unilateral Breast Reconstruction Using Free Abdominal Flaps

Huang, Jung-Ju MD; Wu, Chih-Wei MD; Leon Lam, Wee MB, ChB, MPhil, FRCS (Plast); Lin, Chia-Yu MSc; Nguyen, Dung H. MD; Cheng, Ming-Huei MD, MHA

doi: 10.1097/SAP.0b013e31820859c5
Breast Surgery

Background: Successful breast reconstruction includes the creation of a natural breast mound in addition to achieving maximal symmetry of both breasts. This study investigated the patients' outcome and satisfaction of simultaneous contralateral balancing reduction/mastopexy with unilateral breast reconstruction using free abdominal flaps.

Methods: Between March 2000 and September 2009, 22 of 288 patients underwent unilateral breast reconstructions using a free abdominal flap with simultaneous contralateral breast reduction/mastopexy (group A). The remaining 266 cases were used as the control group (group B). The ultimate cosmesis with the complete pre- and postoperative pictures was assessed. The survey for the quality of life using the Heden questionnaire was obtained from 16 patients in group A.

Results: All 22 flaps survived. Two deep inferior epigastric artery perforator flaps developed venous congestion and subsequent partial flap loss. The mean flap-used weight was 568 ± 128.6 g and 486 ± 158 g in group A and B, respectively (P < 0.01). There were no complications resulted from the reduction/mastopexy. The mean reduced breast tissue was 173.6 ± 101 g (range, 85–355 g). The overall cosmetic scores in group A were higher than in the group B. Of 16 patients, 7 (43.8%) graded this technique as very advantageous and the remaining 9 patients (56.2%) as advantageous.

Conclusions: Simultaneous contralateral balancing procedures including reduction/mastopexy in selected patients can be performed with unilateral breast reconstruction using free abdominal flaps with greater patient satisfaction, minimal increase in operative time, and no increase in complication rates.

From the Division of Reconstructive microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Received July 8, 2010, and accepted for publication, after revision, November 13, 2010.

Presented at the 5th Congress of the World Society for Reconstructive Microsurgery, Okinawa, Japan, June 25–27, 2009; First Asian Symposium for Breast Plastic and Reconstructive Surgery, Taipei Taiwan, May 30–31, 2009; and 10th Congress of the International Confederation for Plastic Reconstructive Aesthetic Surgery, Tokyo, Japan, October 9, 2009.

Conflicts of interest and sources of funding: none declared.

Reprints: Ming-Huei Cheng, MD, MHA, FACS, Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, 5, Fu-Hsing St, Kweishan, Taoyuan 333, Taiwan. E-mail: minghuei@adm.cgmh.org.tw.

© 2011 Lippincott Williams & Wilkins, Inc.