Munhoz Alexandre Mendonça, Aldrighi Cláudia, Buschpiegel Carlos, Ono Carla, Montag Eduardo, Fells Klaus, Arruda Eduardo, Sturtz Gustavo, Kovac Patrick, Filassi José Roberto, Gemperli Rolf, Ferreira Marcus Castro
Division of Plastic Surgery, University of São Paulo School of Medicine, Rua Oscar Freire 1702 ap 78, Sao Paulo, SP, 05409-011, Brazil.
Aesthetic Plast Surg. 2005 May-Jun;29(3):163-8. doi: 10.1007/s00266-004-0103-8.
Transaxillary breast augmentation has gained popularity because of the good aesthetic results and scar placement in a less visible position. As breast-augmented patients age, an increasing number of breast cancer cases can be expected. Sentinel lymph node detection (SLND) is a well-established technique in breast cancer. To date, no information is available regarding the feasibility of SLND for patients with previous transaxillary implants.
A 28-year-old women with bilateral breast hypoplasia underwent a bilateral breast augmentation by the transaxillary approach. One week earlier, SLND was accomplished through two periareolar injections of 0.1 mCi 99m-technetium-labeled fitate and lymphoscintigraphy. A 3.5-cm-long axillary incision was performed, and the dissection continued through the subfascial plane to create the implant's pocket. A silicone gel implant (215 g round, low-profile, textured Silimed) was inserted.
A satisfactory aesthetic result was obtained. Two postoperative lymphoscintigraphies were performed (15 days and 7 months after surgery) with satisfactory SLND. No complication was noted.
The initial data show that SLND in the setting of prior breast implant augmentation through the transaxillary approach is feasible. Additional prospective studies and larger clinical series are necessary to analyze the accuracy of SLND for patients with previous breast implants.
