Damin Andrea Pires, Tiellet Bibiana Quatrin, de Melo Marcia Portela, Zucatto Angela E, Cericatto Rodrigo, Biazus Jorge Villanova
Postgraduate Program in Gynecology and Obstetrics, Federal University of Rio Grande do Sul., Rua Ramiro Barcelos, no. 2400 2° floor, Porto Alegre 90035003, RS, Brazil.
Division of Breast Surgery, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos no. 2350, room 600, Porto Alegre 90035003, RS, Brazil.
J Surg Case Rep. 2024 Sep 11;2024(9):rjae581. doi: 10.1093/jscr/rjae581. eCollection 2024 Sep.
We present a complex case of a patient diagnosed with bilateral breast cancer. The patient initially underwent bilateral skin-sparing mastectomy and immediate subpectoral implant-base breast reconstruction. She had an uncomplicated postoperative recovery. However, three months later, she developed a severe and persistent local infection during adjuvant chemotherapy, resulting in the loss of the breast implants and the formation of massive deforming scars in the chest area. To address this, the patient underwent a series of reconstructive procedures. Lipofilling was used on the chest wall to improve skin quality, followed by a late bilateral transverse rectus abdominis myocutaneous flap for breast reconstruction. Additionally, the final aesthetic result was enhanced by applying a 3-D tattoo. This case highlights the use of a sequence of reconstructive procedures as a feasible alternative to manage complex and extensive scars after failure of primary breast reconstruction.
我们介绍了一例被诊断为双侧乳腺癌的复杂病例。该患者最初接受了双侧保留皮肤的乳房切除术及即刻胸大肌下植入物乳房重建术。术后恢复顺利。然而，三个月后，她在辅助化疗期间出现了严重且持续的局部感染，导致乳房植入物丢失，并在胸部区域形成了大量变形瘢痕。为解决这一问题，患者接受了一系列重建手术。在胸壁进行脂肪填充以改善皮肤质量，随后采用延迟双侧腹直肌肌皮瓣进行乳房重建。此外，通过三维纹身增强了最终的美学效果。该病例强调了一系列重建手术作为原发性乳房重建失败后处理复杂广泛瘢痕的可行替代方案的应用。
