Our Surgical Approach to Treatment of Congenital, Developmental, and Acquired Breast Asymmetries: A Review of 30 Cases
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Peer pressure and the modern definition of beauty have led people to strive for breast perfection. The aim of our study was to emphasize the importance and frequency of nonmastectomy-related breast asymmetry and explain our approach to such patients using a combination of techniques.
We retrospectively reviewed 30 patients with nonmastectomy breast asymmetry (i.e., patients with Poland’s syndrome, tumors, burns, and tuberous breasts) admitted to our clinic between 2001 and 2011. Patients were followed up for a mean of 25 months postoperatively (range 4–72 months). These patients completed a satisfaction questionnaire regarding scarring, size, symmetry, shape, and nipple-areola complex sensation.
Patient distribution and preferred treatment method according to etiology were screened. For mild Poland’s syndrome, breast implants with symmetrization procedures (when needed) were used. In two patients, however, fat grafting was sufficient to correct the deformity. For severe Poland’s syndrome, a tissue expander was first placed and wrapped by regional local flaps, such as the pedicled latissimus dorsi muscle flap, accompanied by fat grafting for infraclavicular depression and an absent anterior axillary fold. After adequate expansion of the skin and muscle flap, a silicone prosthesis replaced the tissue expanders.
Tissue expanders with or without muscle flaps along with fat grafting in multiple sessions are necessary steps in the treatment of breast asymmetry. Knowledge and application of multiple techniques in a step-by-step fashion helps the surgeon to achieve optimal functional and aesthetic results for each patient.
Level of Evidence IV
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KeywordsPoland’s syndrome Nonmastectomy breast asymmetries Developmental anomalies Burn
The authors have no conflicts of interest to disclose.
- 6.Bavinck JN, Waver DD (1986) Subclavian artery supply disruption sequence: hypothesis of a vascular etiology for Poland, Klippel-Feil, and Möbius anomalies. Am J Med 29:903–918Google Scholar
- 18.Blugerman G, Amar R, Schavelzon D, Pelosi II MA, Soto JA, Chomyszyn A, Podda M, Markowsky AV, D’Angelo JA, Moreno R (2011) Advanced lipotransfer techniques. In: Serdev N (ed), Advanced techniques in liposuction and fat transfer. ISBN: 978-953-307-668-3. doi: 10.5772/24745. Available at http://www.intechopen.com/books/advanced-techniques-in-liposuction-and-fat-transfer/advanced-lipotransfer-techniques
- 22.Kaneria MV, Sharbidre P, Burkule D, Shukla A, Somani A, Nabar S (2006) Bilateral breast tuberculosis: a rare entity. J Indian Acad Clin Med 7:61–63Google Scholar
- 24.Nahai F (2005) The art of aesthetic surgery: principles and techniques. Quality Medical Publishing, St. Louis, MOGoogle Scholar
- 27.Poland A (1841) Deficiency of the pectoralis muscles. Guy’s Hospital Rep 6:191Google Scholar
- 32.Rohrich RJ, Hartley W, Brown S (2003) Incidence of breast and chest wall asymmetry in breast augmentation: a retrospective analysis of 100 patients. Plast Reconstr Surg 111:1515–1519Google Scholar
- 35.Von Heimburg D (2000) Refined version of the tuberous breast classification. Plast Reconstr Surg 105:2269–2270Google Scholar