JOURNAL ARTICLE

Immediate versus Delayed Contralateral Breast Symmetrisation in Breast Reconstruction with Latissimus dorsi Flap: A Comparative Study

Salvatore Giordano, Sofia Harkkila, Carlo M Oranges, Pietro G di Summa, Ilkka Koskivuo
Breast Care 2019, 14 (5): 272-276
31798386
To achieve symmetry in unilateral free flap breast reconstruction often requires a contralateral procedure. There is no evidence in the literature to support the benefit of immediate contralateral breast symmetrisation concomitant to breast reconstruction. We hypothesized that performing a simultaneous contralateral balancing operation at the time as the initial reconstruction might provide immediate symmetry and minimize the frequency of secondary procedures. Thus, we performed a comparative study on this issue. A comparative retrospective study was conducted on 78 consecutive patients who underwent unilateral breast reconstruction surgery with latissimus dorsi (LD) flap and contralateral breast symmetrisation from January 2014 to June 2016 at Turku University Hospital. Exclusion criteria included other breast reconstruction techniques and no contralateral symmetrisation at follow-up. The patients were divided according to the timing of contralateral breast balancing operation into an immediate versus a delayed group. Postoperative complications, outcomes, and re-operations were compared. Baseline characteristics were well balanced between the groups except for comorbidity, which was significantly higher in the immediate group. Mastectomy weights (735.6 vs. 390.7 g, p = 0.015), contralateral breast reduction weights (268.3 vs. 105.8 g, p = 0.014), and implant size (218.9 vs. 138.9 g, p = 0.001) were significantly larger in the immediate group. No significant differences in any kind of complications were detected. Similarly, the rates of re-operations were similar among the groups (24.0 vs. 43.3%, p = 0.134). Performing immediate symmetrisation at the time of breast reconstruction is safe and feasible in autologous LD breast reconstructions, where 76% did not require a second operation for symmetry. There were no differences in the rate of any re-operation and, therefore, performance of simultaneous contralateral reduction is a reasonable option.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
31798386
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.