Publication date: Available online 12 March 2019
Source: Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Alexandre K. Dutra, Joel Abdala Junior, Ana Cibele Nagae Fernandes
Abstract
Background
Breast reconstruction with latissimus dorsi myocutaneous flap associated with a breast implant is well established procedure. However, there are few published articles regarding latissimus association with expanders and radiotherapy. This study assess data of breast reconstructions by latissimus dorsi myocutaneous flap associated with Becker expander implant (TLDMF/E) in patients submitted to radiotherapy.
Methods
This is descriptive study consisting of a series of cases. The inclusion criteria was patients who underwent mastectomy, radiotherapy and delayed LDMF/E breast reconstruction. A minimum 6-month follow-up period was established and descriptive variables were analyzed.
Results
123 patients were selected. The mean age of the patients was 45.1 years old. Contralateral breast procedures were performed in 68 patients to achieve symmetry with substitution of the expander for a implant with the majority of patients with a bigger implant than the expander (74.0%) The nipple-areola complex was reconstructed in 77 patients (62.6%). 116 patients (94.3%) had no complications. Minor donor-site complications were seroma in one patient and partial dehiscence in another patient,11 patients (8.9%) had complications in the reconstructed breast such as hematomas, partial native irradiated breast skin necrosis (3 cm or smaller), local infections and partial exposition of the injection port. Major complications were bigger necrosis (3-5 cm) of the native irradiated breast skin in 5 patients (4.0%) who needed repair to avoid exposure of the expander. One patient needed expander removal due to a larger exposition.
Conclusions
Delayed breast reconstruction with TLDMF/E is a reliable option to selected patients with mastectomy and radiotherapy sequel.
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