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Immediate Reconstruction with Tissue Expander after Mastectomy by Periareolar Approach

1996; Wiley; Volume: 2; Issue: 1 Linguagem: Inglês

10.1111/j.1524-4741.1996.tb00074.x

1524-4741

João Carlos Sampaio Góes, Élvio Bueno Garcia,

Reconstructive Facial Surgery Techniques

Abstract: Breast reconstruction in patients submitted to mastectomy for breast cancer treatment restores their physical integrity, reducing the stigma of malignant disease. From March 1992 to January 1995, a tissue expander was used for breast cancer reconstruction in five patients submitted to mastectomy by periareolar approach. This approach allowed the mastologist to remove the entire mammary gland: areola, anteromammary fatty tissue, and axillary lymph nodes in monoblock, keeping a large part of the breast cutaneous lining. The expander was introduced in a subrnuscular pocket consisting of pectoralis major and minor muscles, anterior ser- atus, and anterior aponeurosis of the rectus abdominus, and was partially insufflated with saline solution in the intraoperative stage. The patients were submitted to a second surgery when the expander was removed and a textured silicone gel prosthesis was introduced. The nipple-areola complex was reconstructed and when necessary the opposite breast made symmetrical. The muscular pocket and homogenous expansion directed to the necessary site was associated to the greater amount of better quality skin. This contributed to the achievement of very satisfactory results over a period of 9 months at the minimum and 3 years at the maximum.