Double Asymmetric Circular Incision, a New Skin-Sparing Mastectomy Technique: Results and Outcomes of the First 46 Procedures.

Autor:	Casella D; From the Department of Breast Cancer Surgery, Azienda Ospedaliero-Universitaria Senese., Cassetti D; Department of Medicine, Surgery, and Neurosciences, Unit of General Surgery and Surgical Oncology., Marcasciano M; Department of Oncologic and Reconstructive Breast Surgery, 'Breast Unit Integrata di Livorno'., Lo Torto F; Department of Plastic Reconstructive and Aesthetic Surgery, Sapienza Università di Roma., Fusario D; Department of Medicine, Surgery, and Neurosciences, Unit of General Surgery and Surgical Oncology., Miccoli S; Department of Medicine, Surgery, and Neurosciences, Unit of General Surgery and Surgical Oncology., Fausto A; Department of Diagnostic Imaging, University of Siena., Restaino V; Department of Medicine, Surgery, and Neurosciences, Unit of General Surgery and Surgical Oncology., Ribuffo D; Department of Plastic Reconstructive and Aesthetic Surgery, Sapienza Università di Roma., Neri A; From the Department of Breast Cancer Surgery, Azienda Ospedaliero-Universitaria Senese.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2023 Mar 01; Vol. 151 (3), pp. 384e-387e. Date of Electronic Publication: 2022 Nov 19.
DOI:	10.1097/PRS.0000000000009907
Abstrakt:	Summary: Skin-sparing mastectomy (SSM) is a surgical technique that preserves as much of the breast skin as possible. Double asymmetric circular incision (DACI) is a novel immediate breast reconstruction technique for immediate prepectoral implant placement using a titanium-coated polypropylene mesh. The aim of this technique is to optimize the cosmetic benefits of smaller incisions, preserve breast anatomy, avoid breast deformities, and reduce the negative psychological impact on the patient without increasing local recurrence risk. DACI SSM uses a double circular incision: the external drawing contains the nipple-areola complex, while the inner circular skin island is used to provide the skin for the new areola. The authors performed DACI SSM in patients with tumors located within 2 cm of the nipple-areola complex, or in patients with multicentric lesions involving areolar tissue. Forty-six patients underwent DACI SSM at the authors' institutions between February of 2014 and July of 2019. Two patients developed hematoma, and one patient developed seroma. No implant loss was observed. Skin flap necrosis rate was 0%. The BREAST-Q patient-reported outcomes measure was routinely used at the authors' institutions and recorded good aesthetic outcomes and high patient satisfaction. This new technique appears to be safe and easily reproducible in patients with small to medium-sized breasts and with little to moderate ptosis (up to Regnault classification grade II). Clinical Question/level of Evidence: Therapeutic, IV. (Copyright © 2022 by the American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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