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Open Access
CC BY-NC 4.0 · Arch Plast Surg 2012; 39(03): 216-221
DOI: 10.5999/aps.2012.39.3.216
Original Article

Recipient Vessel Selection in Immediate Breast Reconstruction with Free Abdominal Tissue Transfer after Nipple-Sparing Mastectomy

Authors

  • Sung Jun Yang

    Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

  • Jin Sup Eom

    Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

  • Taik Jong Lee

    Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

  • Sei Hyun Ahn

    Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

  • Byung Ho Son

    Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Background Nipple-sparing mastectomy (NSM) is gaining popularity due to its superior aesthetic results. When reconstructing the breast with free abdominal tissue transfer, we must readdress the recipient vessel, because NSM can cause difficulty in access to the chest vessel.

Methods Between June 2006 and March 2011, a total of 92 women underwent NSM with free abdominal tissue transfer. A lateral oblique incision was used for the nipple-sparing mastectomy. For recipient vessels, the internal mammary vessels were chosen if the mastectomy flap did not block access to the vessels. If it did, the thoracodorsal vessels were used. Age, degree of breast ptosis, weight of the mastectomy specimen, and related complications of the internal mammary vessel group and the thoracodorsal vessel group were compared.

Results Thoracodorsal vessels were used as recipient vessels in 59 cases, and internal mammary vessels in 33 cases including 4 cases with perforators of the internal mammary vessels. Breast reconstruction was successful in all cases except one case involving a total flap failure, which was replaced by a silicone gel implant. The internal mammary group and the thoracodorsal group were similar in terms of age, height, breast weight, and degree of ptosis. The flap related complications such as flap loss and take-back operation rates were not significantly different between the two groups. The rate of nipple necrosis was higher in the internal mammary group.

Conclusions The thoracodorsal vessels could produce comparable outcomes in breast reconstruction after nipple-sparing mastectomies. If access to internal mammary vessels is difficult, the thoracodorsal vessel can be a better choice.

Keywords

Mammaplasty - Mastectomy - Free tissue flaps


Publication History

Received: 13 February 2012

Accepted: 25 April 2012

Article published online:
01 May 2022

© 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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