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CC BY-NC 4.0 · Arch Plast Surg 2014; 41(05): 535-541
DOI: 10.5999/aps.2014.41.5.535
Original Article

The Efficacy of Simultaneous Breast Reconstruction and Contralateral Balancing Procedures in Reducing the Need for Second Stage Operations

Mark L Smith
Department of Surgery, Mount Sinai Beth Israel, New York, NY, USA
,
Emily M Clarke-Pearson
Department of Surgery, Mount Sinai Beth Israel, New York, NY, USA
,
Michael Vornovitsky
Department of Surgery, Mount Sinai Beth Israel, New York, NY, USA
,
Joseph H Dayan
Department of Surgery, Mount Sinai Beth Israel, New York, NY, USA
,
William Samson
Department of Surgery, Mount Sinai St. Luke's-Roosevelt, New York, NY, USA
,
Mark R Sultan
Department of Surgery, Mount Sinai St. Luke's-Roosevelt, New York, NY, USA
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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.

Keywords

Breast neoplasms - Mammoplasty - Free tissue flaps

This article was presented at the Chang Gung-Mayo Clinic Symposium in Reconstructive Surgery on October 2011 in Taipei, Taiwan.




Publication History

Received: 24 February 2014

Accepted: 27 July 2014

Article published online:
05 May 2022

© 2014. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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