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J Reconstr Microsurg
DOI: 10.1055/a-2253-8442
Original Article

The Role of Density in Achieving Volume and Weight Symmetry in Breast Reconstruction

Michael S. Mayr-Riedler   *
1   Department for Plastic, Reconstructive, Hand and Burn Surgery, Munich Clinic Bogenhausen, Munich, Germany
,
Charlotte Topka   *
1   Department for Plastic, Reconstructive, Hand and Burn Surgery, Munich Clinic Bogenhausen, Munich, Germany
,
Simon Schneider
1   Department for Plastic, Reconstructive, Hand and Burn Surgery, Munich Clinic Bogenhausen, Munich, Germany
2   Department for Plastic Surgery and Hand Surgery, Technical University of Munich, Munich, Germany
,
Paul I. Heidekrueger
3   Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
,
Hans-Günther Machens
2   Department for Plastic Surgery and Hand Surgery, Technical University of Munich, Munich, Germany
,
P. Niclas Broer
1   Department for Plastic, Reconstructive, Hand and Burn Surgery, Munich Clinic Bogenhausen, Munich, Germany
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Abstract

Background Knowledge of tissue and implant density is crucial in obtaining both volume and weight symmetry in unilateral breast reconstruction. Therefore, the aim of this study was to determine and compare the density of abdominal and breast tissue specimens as well as of 5th generation breast implants.

Methods Thirty-one breast tissue and 30 abdominal tissue specimens from 61 patients undergoing either mammaplasty or abdominoplasty as well as five different 5th generation breast implants were examined. Density (g/mL) was calculated by applying the water displacement method.

Results The mean specimen density was 0.94 ± 0.02 g/mL for breast tissue and 0.94 ± 0.02 g/mL for abdominal tissue, showing no significant difference (p = 0.230). Breast tissue density significantly (p = 0.04) decreased with age, while abdominal tissue did not. A regression equation to calculate the density of breast tissue corrected for age (breast density [g/mL] = 0.975–0.0007 * age) is provided. Breast tissue density was not related to body mass index, past pregnancy, or a history of breastfeeding. The breast implants had a density ranging from 0.76 to 1.03 g/mL which differed significantly from breast tissue density (–0.19 g/mL [–19.8%] to +0.09 g/mL [+9.58%]; p ≤ 0.001).

Conclusion Our results support the suitability of abdominal-based perforator flaps in achieving both volume and weight symmetry in unilateral autologous breast reconstruction. Abdominal flap volume can be derived one-to-one from mastectomy weight. Further, given significant brand-dependent density differences, the potential to impose weight disbalances when performing unilateral implant-based reconstructions of large breasts should be considered.

Keywords

breast reconstruction - symmetry - density

Presented at: ISAPS World Congress 2021 in Vienna, Austria


The study protocol was approved by the institutional review committee (Technical University of Munich, registration number: 236/18s) and written informed consent was obtained from all patients.




Publication History

Received: 14 July 2023

Accepted: 21 January 2024

Accepted Manuscript online:
25 January 2024

Article published online:
06 March 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
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