Plastic and Reconstructive Surgeon and Fellow at "L'Institut Du Sein-The Paris Breast Centre", Paris, France.
Oncoplastic Breast Surgeon at "L'Institut Du Sein-The Paris Breast Centre", Paris, France.
Eur J Surg Oncol. 2022 Sep;48(9):1925-1928. doi: 10.1016/j.ejso.2022.05.017. Epub 2022 May 25.
Lateral dog ear after mastectomy in overweight or large breasted patients is a source for patient discomfort and is aesthetically unpleasing. Although many different techniques have been proposed, none of them have emerged as standard. In 2012, the authors published their mastectomy technique based on an inverted L-scar incision and closure with a lateral skin flap advanced supero-medially onto the chest wall. Authors sought to report their experience with this technique in patients with wide or large breasts operated with mastectomy without immediate breast reconstruction. As a refinement to their initial technique, they added lipoaspiration to the lateral chest wall.
A retrospective study identified 43 patients operated on using the L incision and lipoaspiration from January 2015 to January 2021. Patient and tumor characteristics, operative details, post-operative results, and complications were recorded. Patients were followed-up and assessed for arm motion restriction, lymphedema, and recurrence.
The mean age was 68 years; the mean BMI was 29 kg/m 2. The mean follow-up was 32 months. The mean weight of the mastectomy specimen was 1009 g and the mean aspirated volume in the lateral chest wall was 450 mL. One patient had a hematoma, four patients had seroma, and one patient developed a minor wound dehiscence. No skin necrosis or arm movement restriction was observed. Two patients developed mild lymphedema. Three patients underwent delayed breast reconstruction.
The proposed technique is a safe and effective method to avoid lateral dog deformity after mastectomy, achieving both functional and cosmetic outcomes.
在超重或乳房较大的患者中，乳房切除术后的外侧狗耳是引起患者不适和不美观的原因。尽管已经提出了许多不同的技术，但没有一种技术成为标准。2012 年，作者发表了他们的乳房切除术技术，该技术基于倒 L 形切口和关闭，外侧皮瓣向上向内推进到胸壁。作者旨在报告他们在接受乳房切除术且不立即进行乳房重建的宽或大乳房患者中使用该技术的经验。作为对初始技术的改进，他们在外侧胸壁上添加了脂肪抽吸术。
回顾性研究确定了 43 例于 2015 年 1 月至 2021 年 1 月期间接受 L 切口和脂肪抽吸术的患者。记录患者和肿瘤特征、手术细节、术后结果和并发症。对患者进行随访并评估手臂运动受限、淋巴水肿和复发情况。
平均年龄为 68 岁；平均 BMI 为 29kg/m 2。平均随访时间为 32 个月。乳房切除术标本的平均重量为 1009g，外侧胸壁的平均抽吸量为 450ml。1 例患者出现血肿，4 例患者出现血清肿，1 例患者出现轻微伤口裂开。未观察到皮肤坏死或手臂运动受限。2 例患者出现轻度淋巴水肿。3 例患者接受了延迟性乳房重建。
该技术是一种安全有效的方法，可以避免乳房切除术后的外侧狗耳畸形，同时实现功能和美容效果。
