Hisamitsu Zaha1. 1. Department of Breast Surgery, Nakagami Hospital, Okinawa, Japan.
Abstract
BACKGROUND: In breast-conserving surgery (BCS), a large defects in the upper inner quadrant (UIQ) named the no man's land of the breast will cause shift the nipple in an unnatural upward or medial fashion. We have developed oncoplastic volume replacement techniques using a laparoscopically harvested omental flap (OF). This paper presents our experiences performing partial breast reconstruction for the defect in the UIQ using the OF. METHODS: A wide excision (>20% of the breast tissue) was performed mainly through a periareolar incision. The pedicled OF was harvested laparoscopically. A small incision was made along the medical inframammary fold and a subcutaneous tunnel was created towards the xyphoid process. The OF was extracted through the tunnel, and used to fill the defect in the UIQ. RESULTS: Thirty patients were included in this study. The median resected breast volume was 142 g. A donor-site complication was only one ventral hernia. The surgical margins were positive in one patient (3.3%), and neither local nor systemic recurrence has occurred during medial follow-up periods of 64 months. Cosmetic outcomes were mostly satisfactory with negligible donor-site scars, and more than 80% of the patients scored excellent or good. CONCLUSIONS: The OF is a useful volume replacement technique for the UIQ which is the most difficult quadrant for the other distant flaps.
BACKGROUND: In breast-conserving surgery (BCS), a large defects in the upper inner quadrant (UIQ) named the no man's land of the breast will cause shift the nipple in an unnatural upward or medial fashion. We have developed oncoplastic volume replacement techniques using a laparoscopically harvested omental flap (OF). This paper presents our experiences performing partial breast reconstruction for the defect in the UIQ using the OF. METHODS: A wide excision (>20% of the breast tissue) was performed mainly through a periareolar incision. The pedicled OF was harvested laparoscopically. A small incision was made along the medical inframammary fold and a subcutaneous tunnel was created towards the xyphoid process. The OF was extracted through the tunnel, and used to fill the defect in the UIQ. RESULTS: Thirty patients were included in this study. The median resected breast volume was 142 g. A donor-site complication was only one ventral hernia. The surgical margins were positive in one patient (3.3%), and neither local nor systemic recurrence has occurred during medial follow-up periods of 64 months. Cosmetic outcomes were mostly satisfactory with negligible donor-site scars, and more than 80% of the patients scored excellent or good. CONCLUSIONS: The OF is a useful volume replacement technique for the UIQ which is the most difficult quadrant for the other distant flaps.
Authors: Steven J Kronowitz; Jules A Feledy; Kelly K Hunt; Henry M Kuerer; Adel Youssef; Cindy A Koutz; Geoffrey L Robb Journal: Plast Reconstr Surg Date: 2006-01 Impact factor: 4.730
Authors: Moustapha Hamdi; Tina Decorte; Martine Demuynck; Bob Defrene; Ann Fredrickx; Georges Van Maele; Herman De Pypere; Koenraad Van Landuyt; Phillip Blondeel; Guy Vanderstraeten; Stan Monstrey Journal: Plast Reconstr Surg Date: 2008-10 Impact factor: 4.730
Authors: Steven J Kronowitz; Henry M Kuerer; Thomas A Buchholz; Vicente Valero; Kelly K Hunt Journal: Plast Reconstr Surg Date: 2008-12 Impact factor: 4.730