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The Expanded Use of Autoaugmentation Techniques in Oncoplastic Breast Surgery

Losken, Albert, M.D.; Hart, Alexandra, M., M.D.; Dutton, James, Walter, M.D.; Broecker, Justine, S., M.D.; Styblo, Toncred, M., M.D.; Carlson, Grant, W., M.D.

Plastic and Reconstructive Surgery: January 2018 - Volume 141 - Issue 1 - p 10–19
doi: 10.1097/PRS.0000000000004009
Breast: Original Articles
Journal Club

Background: Autoaugmentation techniques have been applied to oncoplastic reductions to assist with filling larger, more remote defects, and to women with smaller breasts. The purpose of this report is to describe the use of autoaugmentation techniques in oncoplastic reduction and compare the results with those of traditional oncoplastic reduction.

Methods: The authors queried a prospectively maintained database of all women who underwent partial mastectomy and oncoplastic reduction between 1994 and October of 2015. The autoaugmentation techniques were defined as (1) extended primary nipple autoaugmentation pedicle, and (2) primary nipple pedicle and secondary autoaugmentation pedicle. Comparisons were made to a control oncoplastic group.

Results: There were a total of 333 patients, 222 patients (67.7 percent) without autoaugmentation and 111 patients (33 percent) with autoaugmentation (51 patients with an extended autoaugmentation pedicle, and 60 patients with a secondary autoaugmentation pedicle). Biopsy weight was smallest in the extended pedicle group (136 g) and largest in the regular oncoplastic group (235 g; p = 0.017). Superomedial was the most common extended pedicle, and lateral was the most common location. Inferolateral was the most common secondary pedicle for lateral and upper outer defects. There were no significant differences in the overall complication rate: 15.5 percent in the regular oncoplastic group, 19.6 percent in the extended pedicle group, and 20 percent in the secondary pedicle group.

Conclusions: Autoaugmentation techniques have evolved to manage complex defects not amenable to standard oncoplastic reduction methods. They are often required for lateral defects, especially in smaller breasts. Autoaugmentation can be performed safely without an increased risk of complications, broadening the indications for breast conservation therapy.


This and Related “Classic” Articles Appear on for Journal Club Discussions.

Atlanta, Ga.

From the Division of Plastic and Reconstructive Surgery, Emory University School of Medicine.

Received for publication April 19, 2017; accepted August 3, 2017.

Presented at Plastic Surgery The Meeting 2016, Annual Meeting of the American Society of Plastic Surgeons, in Los Angeles, California, September 23 through 27, 2016.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Albert Losken, M.D., Division of Plastic and Reconstructive Surgery Emory University School of Medicine, 550 Peachtree Street NE, Suite 9000, Atlanta, Ga. 30308,

©2018American Society of Plastic Surgeons