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CC BY 4.0 · Arch Plast Surg 2025; 52(03): 119-124
DOI: 10.1055/a-2525-5772
Breast/Trunk
Idea and Innovation

Downward Repositioning of Breast Mound with Early Phase Intervention for Autologous Breast Reconstruction Patients

Makoto Shimabukuro 
1   Department of Plastic and Reconstructive Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
2   Department of Plastic and Reconstructive Surgery, International University of Health and Welfare, School of Medicine, Chiba, Japan
,
Naohiro Ishii 
1   Department of Plastic and Reconstructive Surgery, International University of Health and Welfare Hospital, Tochigi, Japan
2   Department of Plastic and Reconstructive Surgery, International University of Health and Welfare, School of Medicine, Chiba, Japan
,
Naohiko Ikura 
3   Department of Plastic and Reconstructive Surgery, Tochigi Cancer Center, Tochigi, Japan
,
Kyoichi Matsuzaki 
2   Department of Plastic and Reconstructive Surgery, International University of Health and Welfare, School of Medicine, Chiba, Japan
,
Kazuo Kishi 
4   Department of Plastic and Reconstructive Surgery, Keio University, Tokyo, Japan
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Abstract

In breast reconstruction with a flap transfer, symmetry is often difficult to achieve when the contralateral breast projection has a downward peak. Although minimally invasive and effective methods for postoperative correction of the reconstructed breast mound are desirable, none has been comprehensively reported. We devised a correction method comprising downward movement of the reconstructed breast mound using early postoperative dissection and pressure. This method was applied to four patients undergoing primary two-stage ptotic breast reconstruction with a flap transfer. All of their reconstructed breast mounds were positioned above the contralateral side in the early postoperative period. They underwent manual dissection of the upper edge in flaps under local anesthesia 3 weeks after reconstruction or downward pressure correction using a sponge for 6 months or both procedures. The reconstructed breast mound moved 2 to 2.5 cm downward with early postoperative manual dissection or pressure correction using a sponge and moved 3 cm downward with the combination of both dissection and pressure. Manual dissection in the early postoperative period under local anesthesia and compression with a sponge is minimally invasive and useful for the downward correction of the reconstructed breast mound. The combination of dissection and compression provides a greater corrective effect.

Keywords

breast mound - ptosis - reconstruction - skin flap - sponge

Authors' contributions

Conceptualization: M.S., N.I., N.I.

Data curation: M.S., N.I., N.I.

Formal analysis: M.S., N.I., K.M., K.K.

Methodology: M.S., N.I., N.I.

Project administration: K.M., K.K.

Visualization: M.S., N.I., N.I.

Writing—original draft: M.S., N.I., N.I., K.M., K.K.

Writing—review and editing: M.S., N.I., N.I., K.M., K.K.


Ethical Approval

The study was approved by the Ethics Committee of the Tochigi cancer center (IRB No. 23-A049) and performed in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained.


Patient Consent

The patients provided written informed consent for the publication and the use of their images.




Publikationsverlauf

Eingereicht: 14. Februar 2024

Angenommen: 17. Januar 2025

Accepted Manuscript online:
28. Januar 2025

Artikel online veröffentlicht:
24. März 2025

© 2025. 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/)

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