However, this patient was elderly, and did not want to undergo a complicated reconstruction procedure. For patients who suffer from prolonged seroma, radical capsulectomy with breast reconstruction using autologous tissue, such as a deep inferior epigastric artery perforator free flap, is preferred as a treatment choice at our center. In this report, we present the case of a 74-year-old woman with a history of failure of postmastectomy immediate breast reconstruction with an implant and ADM. If breast reconstruction is not successfully performed with a prosthetic implant, this technique could be used to construct a breast mound and prepare the tissue for secondary surgery. Moreover, the Goldilocks technique could be applied as a salvage technique following the failure of initial reconstruction. The ideal patients for this technique include women who are candidates for skin-sparing mastectomy and have macromastia or significant breast ptosis. This technique has been traditionally used for breast reconstruction in women who are poor candidates for conventional methods due to increased risks associated with obesity or medical comorbidities and in those who decline a complicated reconstruction procedure and focus on simplifying the treatment for individual reasons. After skin-sparing mastectomy, the de-epithelialized mastectomy flap within the boundary of the Wise pattern incision is molded to produce the breast volume. This technique utilizes the redundant inferior mastectomy flap tissue to construct a breast mound. Richardson and Ma described the Goldilocks mastectomy technique in 2012. However, information on the incidence of seroma formation remains limited, warranting standardized reporting. In a meta-analysis, the rate of seroma formation after implant-based breast reconstruction using ADM was 4.8% to 6.9%. According to the existing literature, ADM is associated with an increased risk of seroma. Īfter acellular dermal matrix (ADM) was introduced for breast reconstruction procedures in 2001, the combination of nipple- and skin-sparing mastectomy and immediate breast reconstruction with ADM and submuscular implant placement has become significantly more common. Various causes of late seroma development have been reported, including infection, implant rupture, mechanical shearing, and breast implantassociated anaplastic large cell lymphoma. Peri-implant seroma is a common complication of breast prosthetic reconstruction and mammoplasty. Currently, there are several different approaches for reconstruction using prosthetic implants and autologous tissues, each with its own indications, related complications, advantages, and disadvantages. In the past few years, skin-sparing mastectomy has become an extremely popular and oncologically safe option for women with breast cancer.
0 Comments
Leave a Reply. |