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LATISSIMUS DORSI MYOCUTANEOUS FLAP WITH ANATOMICAL EXPANDER‐IMPLANTS FOR SINGLE STAGE BREAST RECONSTRUCTION – AN ACHIEVABLE GOAL?
Author(s) -
Dunkin C. S. J.,
Jeeves A.,
Wiener M.,
Mackie I.,
Caddy C. M.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04127_14.x
Subject(s) - medicine , breast reconstruction , capsular contracture , surgery , implant , single stage , mastectomy , stage (stratigraphy) , tissue expander , areola , breast cancer , cancer , paleontology , aerospace engineering , engineering , biology
Implant‐based breast reconstruction has evolved from two‐stage methods using round smooth expanders to single‐stage using definitive textured biodimensional anatomical expander‐prostheses. The aim of this study was to assess if single‐stage reconstruction is achievable using McGhan 150 expander‐implants with latissimus dorsi (LD) myocutaneous flaps and if so, at what cost. Methods Data was collected retrospectively on all women who underwent this type of breast reconstruction, between 1997–2005, with a minimum of 6 months follow‐up. Results 147 patients had 164 reconstructions (17 bilateral cases). Mean age 48 ± 9 years. The indications for reconstruction were mastectomy, breast asymmetry and Poland’s syndrome. 144 patients had pedicled flaps and 3 patients had contralateral free flaps. The majority were delayed reconstructions. Single‐stage reconstruction was achieved in 81/147 patients. The number of procedures per completed reconstruction was 2.2 or 1.9 if nipple‐areola reconstruction and contralateral surgery were excluded. The overall complication rate was 38%. Implants were removal for infection in 12% and exchanged for capsular contracture in 15%. LD/expander‐implant reconstruction failed in 3 patients. Conclusions Single‐stage reconstruction is an achievable goal but patients should be counselled that further surgery might be required to complete the reconstruction.