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Smith, Mark L.,Clarke-Pearson, Emily M.,Vornovitsky, Michael,Dayan, Joseph H.,Samson, William,Sultan, Mark R. Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.5
Background Patients having unilateral breast reconstruction often require a second stage procedure on the contralateral breast to improve symmetry. In order to provide immediate symmetry and minimize the frequency and extent of secondary procedures, we began performing simultaneous contralateral balancing operations at the time of initial reconstruction. This study examines the indications, safety, and efficacy of this approach. Methods One-hundred and two consecutive breast reconstructions with simultaneous contralateral balancing procedures were identified. Data included patient age, body mass index (BMI), type of reconstruction and balancing procedure, specimen weight, transfusion requirement, complications and additional surgery under anesthesia. Unpaired t-tests were used to compare BMI, specimen weight and need for non-autologous transfusion. Results Average patient age was 48 years. The majority had autologous tissue-only reconstructions (94%) and the rest prosthesis-based reconstructions (6%). Balancing procedures included reduction mammoplasty (50%), mastopexy (49%), and augmentation mammoplasty (1%). Average BMI was 27 and average reduction specimen was 340 grams. Non-autologous blood transfusion rate was 9%. There was no relationship between BMI or reduction specimen weight and need for transfusion. We performed secondary surgery in 24% of the autologous group and 100% of the prosthesis group. Revision rate for symmetry was 13% in the autologous group and 17% in the prosthesis group. Conclusions Performing balancing at the time of breast reconstruction is safe and most effective in autologous reconstructions, where 87% did not require a second operation for symmetry.
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Mark L Smith,Emily M Clarke-Pearson,Michael Vornovitsky,Joseph H Dayan,William Samson,Mark R Sultan 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.5
Background: Patients having unilateral breast reconstruction often require a second stageprocedure on the contralateral breast to improve symmetry. In order to provide immediatesymmetry and minimize the frequency and extent of secondary procedures, we beganperforming simultaneous contralateral balancing operations at the time of initial reconstruction. This study examines the indications, safety, and efficacy of this approach. Methods: One-hundred and two consecutive breast reconstructions with simultaneouscontralateral balancing procedures were identified. Data included patient age, body massindex (BMI), type of reconstruction and balancing procedure, specimen weight, transfusionrequirement, complications and additional surgery under anesthesia. Unpaired t-tests wereused to compare BMI, specimen weight and need for non-autologous transfusion. Results: Average patient age was 48 years. The majority had autologous tissue-only reconstructions(94%) and the rest prosthesis-based reconstructions (6%). Balancing proceduresincluded reduction mammoplasty (50%), mastopexy (49%), and augmentation mammoplasty(1%). Average BMI was 27 and average reduction specimen was 340 grams. Non-autologousblood transfusion rate was 9%. There was no relationship between BMI or reduction specimenweight and need for transfusion. We performed secondary surgery in 24% of the autologousgroup and 100% of the prosthesis group. Revision rate for symmetry was 13% in theautologous group and 17% in the prosthesis group. Conclusions: Performing balancing at the time of breast reconstruction is safe and mosteffective in autologous reconstructions, where 87% did not require a second operation forsymmetry.
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