CC BY 4.0 · Arch Plast Surg 2023; 50(06): 550-556
DOI: 10.1055/a-2121-7560
Breast/Trunk
Case Report

Breast Reconstruction after Blunt Breast Trauma: Systematic Review and Case Report Using the Ribeiro Technique

1   Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute, Buenos Aires, Argentina
,
1   Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute, Buenos Aires, Argentina
,
1   Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute, Buenos Aires, Argentina
,
1   Plastic Surgery Department, Hospital Italiano de Buenos Aires, University of Buenos Aires Medical School, Hospital Italiano de Buenos Aires University Institute, Buenos Aires, Argentina
› Author Affiliations

Abstract

Blunt breast trauma occurs in 2% of blunt chest injuries. This study aimed to evaluate the evidence on breast reconstruction after blunt trauma associated with the use of a seat belt. Also, we describe the first case of breast reconstruction using the Ribeiro technique. In November 2022, a systematic search of MEDLINE, EMBASE, and Google Scholar databases was conducted. The literature was screened independently by two reviewers, and the data was extracted. Our search terms included breast, mammoplasty, blunt injury, and seat belts. In addition, we present the case of a woman with a left breast deformity and her reconstruction using the inferior Ribeiro flap technique. Six articles were included. All included studies were published between 2010 and 2021. The studies recruited seven patients. According to the Teo and Song classification, seven class 2b cases were reported. In five cases a breast reduction was performed in the deformed breast with different types of pedicles (three superomedial flaps, one lower flap, one superior flap). Only one case presented complications. The case here presented was a type 2b breast deformity in which the lower Ribeiro pedicle was used successfully without complications during follow-up. Until now there has been no consensus on reconstructive treatment due to the rarity of this entity. However, we must consider surgical treatment individually for each patient. We believe that the Ribeiro technique is a feasible and safe alternative in the treatment of posttraumatic breast deformities, offering very good long-term results.

Authors' Contributions

R.M.P.H. and M.F.R. drafted the manuscript. I.T.P.B. and H.F.M. supervised the writing of the manuscript. I.T.P.B. and H.F.M. performed perioperative management and operation of the patient. All authors read and approved the final manuscript.


Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The local research ethics committee has confirmed that no ethical approval is required for case reports.


Patient Consent

Patient signed informed consent regarding publishing her data and photographs.




Publication History

Received: 26 November 2022

Accepted: 15 June 2023

Accepted Manuscript online:
03 July 2023

Article published online:
30 November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Sanders C, Cipolla J, Stehly C, Hoey B. Blunt breast trauma: is there a standard of care?. Am Surg 2011; 77 (08) 1066-1069
  • 2 Cummings P. Association of seat belt use with death: a comparison of estimates based on data from police and estimates based on data from trained crash investigators. Inj Prev 2002; 8 (04) 338-341
  • 3 Paddle AM, Morrison WA. Seat belt injury to the female breast: review and discussion of its surgical management. ANZ J Surg 2010; 80 (1-2): 71-74
  • 4 Song CT, Teo I, Song C. Systematic review of seat-belt trauma to the female breast: a new diagnosis and management classification. J Plast Reconstr Aesthet Surg 2015; 68 (03) 382-389
  • 5 Pitanguy I. Surgical treatment of breast hypertrophy. Br J Plast Surg 1967; 20 (01) 78-85
  • 6 Ribeiro L, Accorsi Jr A, Buss A, Marcal-Pessoa M. Creation and evolution of 30 years of the inferior pedicle in reduction mammaplasties. Plast Reconstr Surg 2002; 110 (03) 960-970
  • 7 Page MJ, McKenzie JE, Bossuyt PM. et al. Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. J Clin Epidemiol 2021; 134: 103-112
  • 8 Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016; 5 (01) 210
  • 9 Scevola A, Viard R, Veber M, Toussoun G, Delay E. Fracture du sein: présentation, diagnostic et prise en charge chirurgicale de deux cas. Ann Chir Plast Esthet 2011; 56 (04) 329-333
  • 10 Petrie NC. Response to “Seat belt injury causing bisection of the breast: a case report”. J Plast Reconstr Aesthet Surg 2015; 68 (03) 429-431
  • 11 Noel OF, Fornadley J, Potochny J. Restoring the severed breast and chest following seat belt trauma. Plast Reconstr Surg Glob Open 2020; 8 (05) e2849
  • 12 Lafford G, Mulgrew S, Köhler G, Haywood R. Seat belt breast injury: a reconstructive approach to managing unilateral bisected breast deformity. BMJ Case Rep 2021; 14 (07) e243065
  • 13 Majeski J. Shoulder restraint injury of the female breast. Int Surg 2007; 92 (02) 99-102
  • 14 Akan M, Yildirim S, Misirlioğlu A, Gideroğlu K, Aköz T. An interesting mammary implant rupture: seat belt injury. Plast Reconstr Surg 2003; 111 (05) 1763-1765
  • 15 Fodor L, Moscona R. Late post-traumatic intracapsular seroma after breast augmentation. J Plast Reconstr Aesthet Surg 2009; 62 (12) e609-e610
  • 16 Teo I, Dujon D, Azmy I. Seat belt injury causing bisection of the breast: a case report. J Plast Reconstr Aesthet Surg 2014; 67 (07) 1008-1009
  • 17 Economides JM, Graziano F, Tousimis E, Willey S, Pittman TA. Expanded algorithm and updated experience with breast reconstruction using a staged nipple-sparing mastectomy following mastopexy or reduction mammaplasty in the large or ptotic breast. Plast Reconstr Surg 2019; 143 (04) 688e-697e
  • 18 Ribeiro Liacyr. Pediculos en Mamoplastia. Atlas y texto. AMOLCA 2009: 262