Francesca De Lorenzi1, Francesco Borelli2, Mario Alessandri-Bonetti3,4, Alberto Marchetti1, Leonardo Pires Novais Dias1, Alessandra Invento5, Elisabetta Maria Cristina Rossi5, Pietro Loschi1, Paolo Veronesi5,4. 1. Department of Plastic and Reconstructive Surgery, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy. 2. Department of Plastic and Reconstructive Surgery, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy. francesco.borelli@unimi.it. 3. Department of Reconstructive and Aesthetic Plastic Surgery, University of Milan, I.R.C.C.S. Istituto Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy. 4. University of Milan, Milan, Italy. 5. Department of Breast Surgery, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy.
Abstract
INTRODUCTION: Oncoplastic surgery (OPS) allows wide excisions and accurate tumor resection and reduces breast deformities by immediate reconstruction of large defects. Superior pedicled mammaplasties allow excellent results in large breasts. Conversely, loco-regional flaps are the standard of care in small-to-medium breasts. However, both techniques show limitations in case of large resections of the lower pole, resulting in skin retraction and downward deviation of nipple and areola. We present a new technique for inferior pole reconstruction to overcome these limitations. It is called "the three-petal reconstruction" (3-PR). METHODS: Between September 2016 and May 2019, ten patients with invasive breast cancer of the lower pole underwent breast conservation and 3-PR. RESULTS: The 3-PR was uneventful in all patients. No major or minor complications were recorded. Patient and surgeon evaluations scored as good to excellent in all cases. Surveillance examinations in the follow-up did not reveal calcifications nor any findings of suspicion within the reconstructed area. CONCLUSIONS: In case of very large defect of lower pole, the 3-PR reveals to be an easy, fast, reproducible method for inferior pole reconstruction. It can represent a niche between therapeutic mammaplasty and perforator flaps, and it could be added to existing available options for tailored reconstruction. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
INTRODUCTION: Oncoplastic surgery (OPS) allows wide excisions and accurate tumor resection and reduces breast deformities by immediate reconstruction of large defects. Superior pedicled mammaplasties allow excellent results in large breasts. Conversely, loco-regional flaps are the standard of care in small-to-medium breasts. However, both techniques show limitations in case of large resections of the lower pole, resulting in skin retraction and downward deviation of nipple and areola. We present a new technique for inferior pole reconstruction to overcome these limitations. It is called "the three-petal reconstruction" (3-PR). METHODS: Between September 2016 and May 2019, ten patients with invasive breast cancer of the lower pole underwent breast conservation and 3-PR. RESULTS: The 3-PR was uneventful in all patients. No major or minor complications were recorded. Patient and surgeon evaluations scored as good to excellent in all cases. Surveillance examinations in the follow-up did not reveal calcifications nor any findings of suspicion within the reconstructed area. CONCLUSIONS: In case of very large defect of lower pole, the 3-PR reveals to be an easy, fast, reproducible method for inferior pole reconstruction. It can represent a niche between therapeutic mammaplasty and perforator flaps, and it could be added to existing available options for tailored reconstruction. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Authors: M Rietjens; C A Urban; P C Rey; G Mazzarol; P Maisonneuve; C Garusi; M Intra; S Yamaguchi; N Kaur; F De Lorenzi; A G Z Matthes; S Zurrida; J Y Petit Journal: Breast Date: 2007-03-26 Impact factor: 4.380
Authors: Krishna B Clough; Gabriel J Kaufman; Claude Nos; Ines Buccimazza; Isabelle M Sarfati Journal: Ann Surg Oncol Date: 2010-02-06 Impact factor: 5.344
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