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Capsular Grafts and Flaps in Immediate Prosthetic Breast Reconstruction

  • Innovative Techniques
  • Breast
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Abstract

Background

Patients with previously augmented breasts and a diagnosis of breast cancer who are candidates for immediate prosthetic reconstruction can benefit from capsular tissues used for splinting the position of the pectoralis major muscle.

Methods

A retrospective clinical review of patients with previously augmented breasts who are undergoing mastectomy and immediate prosthetic reconstruction with capsular tissues was undertaken. The bottom of the periprosthetic capsule was tailored in a novel and versatile fashion as grafts or flaps and used as a sling between the pectoralis major and the inframammary fold.

Results

Of the 21 patients in this study, 19 had unilateral reconstruction, whereas 2 had bilateral reconstructions. Capsular tissues were harvested as free capsular grafts in 15 cases and raised as a capsular flap in the remaining 8 cases. During the follow-up period, complications were detected in 7 patients (1 seroma, 1 infection, 1 hematoma, 1 superficial epidermolysis, 2 cases of rippling, and 1 mild capsular contracture).

Conclusions

For eligible patients, the use of capsular tissues offers a readily available and cost-effective alternative to acellular dermal matrices with a negligible complication rate. Patient selection is key to ensuring a safe oncologic approach and must be carefully carried out in close collaboration with the breast surgeon.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article

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Authors and Affiliations

  1. Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires School of Medicine, Perón 4190, 1st Floor (1181), Buenos Aires, Argentina

    Horacio F. Mayer & Hugo D. Loustau

Authors
  1. Horacio F. Mayer
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  2. Hugo D. Loustau
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Correspondence to Horacio F. Mayer.

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Mayer, H.F., Loustau, H.D. Capsular Grafts and Flaps in Immediate Prosthetic Breast Reconstruction. Aesth Plast Surg 38, 129–138 (2014). https://doi.org/10.1007/s00266-013-0249-3

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  • DOI: https://doi.org/10.1007/s00266-013-0249-3

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