Zusammenfassung
Die Sofortrekonstruktion der kleinen bis mittelgroßen Brust mit Silikonimplantaten
hat sich als technisch einfaches und relativ sicheres rekonstruktives Verfahren etabliert.
Nachteilig ist das zweizeitige Vorgehen mit Implantation einer Expanderprothese und
späterem Implantatwechsel sowie die lange über die Brust ziehende Mastektomienarbe.
Durch eine modifizierte Operationstechnik mit rein periareolärem Zugang für die hautsparende
Mastektomie, Präparation eines Muskellappens aus Anteilen der Mm. obliquus externus,
serratus anterior und pectoralis major sowie speziellem Wundverschluss kann in nur
einer Sitzung ein günstiges Rekonstruktionsergebnis mit weitgehend narbenfreier Brusthaut
erzielt werden.
Abstract
Immediate breast reconstruction using silicone implants has proven to be an effective
and safe method. Disadvantageous are the two-stage procedure with expander and implant
and the visibility of the oblique mastectomy scar. Using a skin-sparing mastectomy
technique with a periareolar incision only, preparation of a muscle flap containing
Mm. obliquus externus, serratus anterior und pectoralis major and a special wound
closure, excellent reconstruction results with almost invisible scars may be achieved
in just one operative setting.
Schlüsselwörter
Sofortrekonstruktion der Brust - Silikongelimplantate - hautsparende Mastektomie
Key words
Immediate breast reconstruction - silicone implants - skin-sparing mastectomy
Literatur
- 1
Elliott L, Eskenazi L, Beegle P H, Podres P E, Drazan L.
Immediate TRAM flap breast reconstruction: 128 consecutive cases.
Plast Reconstr Surg.
1993;
92
217-227
- 2
Gabka C J, Maiwald G, Bohmert H.
Immediate breast reconstruction for breast carcinoma using the periareolar approach.
Plast Reconstr Surg.
1998;
101
1228-1234
- 3
Greenbaum S S, Radonich M.
Closing skin defects with purse-string suture.
Plast Reconstr Surg.
1998;
101
1749-1751
- 4
Kroll S S, Khoo A, Singletary S E, Ames F C, Wang B G, Reece G P, Miller M J, Evans G R,
Robb G L.
Local recurrence risk after skin-sparing and conventional mastectomy: a 6-year follow-up.
Plast Reconstr Surg.
1999;
104
421-425
- 5
Langstein H N, Cheng M H, Singletary S E, Robb G L, Hoy E, Smith T L, Kroll S S.
Breast cancer recurrence after immediate reconstruction: patterns and significance.
Plast Reconstr Surg.
2003;
111
712-720
- 6
Maxwell G P, Falcone P A.
Eighty-four consecutive breast reconstructions using a textured silicone tissue expander.
Plast Reconstr Surg.
1992;
89
1022-1034
- 7
Peled I J, Zagher U.
Purse-string suture for reduction and closure of skin defects.
Ann Plast Surg.
1985;
14
465-469
- 8
Spear S L, Majidian A.
Immediate breast reconstruction in two stages using textured, integrated-valve tissue
expanders and breast implants: a retrospective review of 171 consecutive breast reconstructions
from 1989 to 1996.
Plast Reconstr Surg.
1998;
101
53-63
- 9
Spear S L, Spittler C J.
Breast reconstruction with implants and expanders.
Plast Reconstr Surg.
2001;
107
177-187
- 10
Toth B A, Forley B G, Calabria R.
Retrospective study of the skin-sparing mastectomy in breast reconstruction.
Plast Reconstr Surg.
1999;
104
77-84
- 11
Toth B A, Daane S P.
Purse-string mastectomy with immediate prosthetic reconstruction: an improved skin-sparing
technique for small breasts.
Plast Reconstr Surg.
2003;
111
2333-2337
- 12
Tremolada C, Blandini D, Beretta M, Mascetti M.
The “round block” purse-string suture: a simple method to close skin defects with
minimal scarring.
Plast Reconstr Surg.
1997;
100
126-131
Priv.-Doz. Dr. med. Christian J. Gabka
Praxis für Plastische Chirurgie
Böcklinstraße 1
80638 München
URL: http://www.Gabka.de
