CC BY-NC-ND 4.0 · Indian J Plast Surg 2014; 47(01): 127-131
DOI: 10.4103/0970-0358.129646
Case Report
Association of Plastic Surgeons of India

Custom-made approach to a patient with post-burn breast deformity

Yalcin Bayram
Departments of Plastic Reconstructive and Aesthetic Surgery and Burn Unit, Gulhane Military Medical Academy, Ankara
,
Cihan Sahin
1   Departments of Plastic Reconstructive and Aesthetic Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Kadikoy, Istanbul, Turkey
,
Celalettin Sever
1   Departments of Plastic Reconstructive and Aesthetic Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Kadikoy, Istanbul, Turkey
,
Huseyin Karagoz
1   Departments of Plastic Reconstructive and Aesthetic Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Kadikoy, Istanbul, Turkey
,
Yalcin Kulahci
2   Department of Hand and Upper Extremity Surgery, Gulhane Military Medical Academy, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

Publication Date:
26 August 2019 (online)

ABSTRACT

Second and third degree burns on breasts at preadolescent period may cause severe breast deformations. This deformation can be variable depending on severity and location of the burns, personal adolescent patterns, and treatment modality in acute burn period. A 21 year old female patient admitted to our department for her breast deformation due to burn contracture at the inferior pole of the right breast. On physical examination we defined that development of the volume of the right breast was equal to the left, and inferior pole of the right breast was flattened due to contracture, and nipple was projected to inferior. We found that inframammary crease of the right breast was 2 cm lower than that of left; andthe distance of nipple-inframamary crease was 4.7 cm while areola-inframmary crease was 2 cm. New nipple-areola complex level was identified according to left breast’s level. Medial and lateral lines were planned to merge inferiorly at 2 cm above inframmary crease in a plan similar to vertical mammaplasty. Superior pedicle carrying nipple areola was desepitelised. Lower parenchymal V flap was transposed superiorly and attached to the pectoral muscle. Inferior parts of the lateral and medial glandular flaps were excised to form new inframammary crease. The desired laxity of skin at the lower pole was obtained by performing a new Z- plasty between lateral and medial skin flaps. Breast symmetry was confirmed by postoperative objective measurements between left and right breasts. Patient’s satisfaction and aesthetic appearance levels were high. Breasts deformation patterns caused by burns, trauma and mass exsicion due to cancer could not be addressed with traditional defined techniques. Special deformations can be corrected by custom made plannings as we presented here.

 
  • REFERENCES

  • 1 Grishkevich VM. Restoration of the shape, location and skin of the severe burn-damaged breast. Burns 2009; 35: 1026-35
  • 2 El-Otiefy MA, Darwish AM. Post-burn breast deformity: Various corrective techniques. Ann Burns Fire Disasters 2011; 24: 42-5
  • 3 MacLennan SE, Wells MD, Neale HW. Reconstruction of the burned breast. Clin Plast Surg 2000; 27: 113-9
  • 4 Wainwright DJ. Burn reconstruction: The problems, the techniques, and the applications. Clin Plast Surg 2009; 36: 687-700
  • 5 Durmus M. How to approach a patient who refuses the recommended mammoplasty technique. Arch Clin Exp Surg 2013; 2: 69-70
  • 6 Sever C, Uygur F, Kulahci Y, Oksuz S, Sahin C, Yuksel F. Treatment of facial burn scars with CO2 laser resurfacing and thin skin grafting. J Craniofac Surg 2010; 21: 1024-8
  • 7 Kulahci Y, Sever C, Noyan N, Uygur F, Ates A, Evinc R. et al. Burn assault with paint thinner ignition: An unexpected burn injury caused by street children addicted to paint thinner. J Burn Care Res 2011; 32: 399-404
  • 8 Ozgur F, Gokalan I, Mavili E, Erk Y, Kecik A. Reconstruction of postburn breast deformities. Burns 1992; 18: 504-9
  • 9 McCauley RL. Reconstruction of the trunk and genitalia. In Herndon D. editor Total Burn Care. Philadelphia: W.B. Saunders; 2002: 707-10
  • 10 McCauley RL, Killion GW, Boven K. Reconstruction of the burned breast and nipple - areolar complex. In McCauley RL. editor Functional and Aesthetic Reconstruction of Burned Patients. Boca Raton: Taylor and Francis; 2005: 379-91
  • 11 Haik J, Grabov-Nardini G, Goldan O, Tessone A, Regev E, Mendes D. et al. Expanded reverse abdominoplasty for reconstruction of burns in the epigastric region and the inframammary fold in female patients. J Burn Care Res 2007; 28: 849-53
  • 12 Neale HW, Smith GL, Gregory RO, MacMillan BG. Breast reconstruction in the burned adolescent female (an 11-year, 157 patient experience). Plast Reconstr Surg 1982; 70: 718-24
  • 13 Kunert P, Schneider W, Flory J. Principles and procedures in female breast reconstruction in the young child′s burn injury. Aesthetic Plast Surg 1988; 12: 101-6
  • 14 Palao R, Gómez P, Huguet P. Burned breast reconstructive surgery with Integra dermal regeneration template. Br J Plast Surg 2003; 56: 252-9
  • 15 Slator RC, Wilson GR, Sharpe DT. Postburn breast reconstruction: Tissue expansion prior to contracture release. Plast Reconstr Surg 1992; 90: 668-71