Strategies in the management of post-burn breast deformities
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Burn injuries to the chest area may end up with severe breast deformity and asymmetry. They are frequently complex and unique to each case, affecting parenchymal development, breast implantation on chest wall, nipple areola complex position, infra-mammary fold definition, and skin envelope. Furthermore, contractures affecting adjacent territories may occur and add to the deformity. Surgical correction should address all the deformity components. Thus, a structured reconstructive plan that recruits different mammaplasty techniques and deals with adjacent territories is needed. This work presents different strategies used in treating severe post-burn breast deformities. Elaborate analyses of the deformities, surgical techniques, and outcomes are presented and a structured reconstructive plan is proposed.
Sixteen deformed breasts in 11 patients (mean age, 22 years) were managed. The techniques used included a variety of mastopexy techniques, prosthesis-based endoscopic breast reconstruction, and autologous breast augmentation with fat grafting or local flaps in some hypoplastic cases. Ancillary procedures to the neck, axilla, and abdomen were carried out to release the breast when tethered by their contractures.
Considerable improvement and reasonable symmetry were achieved in most cases. All patients were satisfied with the results, tolerated the need for multiple procedures, and accepted residual minor asymmetries.
A post-burn breast deformity has a complex nature that may be addressed on multiple stages with different techniques of mastopexy, augmentation, and reconstruction. Ancillary procedures to a contracted adjacent territory may be needed to release the breast if tethered. Adopting a structured reconstructive plan may help obtain reproducible constant results.
Level of Evidence: Level IV, therapeutic study.
KeywordsBurn Breast deformity Reconstruction Strategies
Conflict of interest
- 5.McCauley RL (2003) Reconstruction of the trunk and genitalia. In: Herndon D (ed) Total burn care, 2nd edn., vol. 2. Saunders, London, p 707Google Scholar
- 6.Fish J (2006) Reconstruction of the burned breast and abdomen. In: Sood R (ed) Achauer and Sood’s burn surgery reconstruction and rehabilitation, 1st edn. Saunders, Philadelphia, pp 264–272Google Scholar
- 7.Sakr W (2002) Local fasciocutaneous flaps in managing postburn breast deformities. Egypt J Plast Reconstr Surg 26:233–239Google Scholar
- 9.Vasconez LO, Lejour M, Mabel G (1991) Contralateral upper rectus flap for breast reconstruction. In: Popow D (ed) Atlas of breast reconstruction, 1st edn. Gower Medical, New York, pp 5.2–5.4Google Scholar
- 12.Coleman SR (2011) Structural fat grafting: basics and clinical applications in the hand, face and nose. In: Nahai F (ed) The art of aesthetic surgery: principles and techniques, vol 2, 2nd edn. Quality Medical Publishing, St. Louis, pp 395–473Google Scholar
- 18.Neale HW, Kurtzman LC (1991) Reconstruction of the burned breast and abdomen. In: Achauer BM (ed) Burn reconstruction. Thieme Medical, New York, pp 148–164Google Scholar