Breast tissue density as a predictor of complications in reconstructive and plastic surgery

Abstract

Aesthetic breast surgery is consistently a leading position in plastic surgery. According to the International Society of Aesthetic Plastic Surgery (ISAPS), in 2019, 1 795 551 breast augmentations were performed. However, as the number of primary surgeries increases, so does the percentage of complications and consequent patient dissatisfaction with the primary intervention results. Approximately 20% of women experience postoperative complications, such as breast asymmetry, implant displacement, double fold (“double bubble”), rippling, capsular contracture, seroma, hematoma, suture dehiscence, and others. Women with decreased breast tissue tone due to postinvolutive changes are at risk for postoperative complications. The risk of complications also increases when not just breast augmentation, but a combination of augmentation and mastopexy is required. In most cases, when a surgical intervention is recommended in several stages, patients are not willing to wait for a long time. This group of women is the most difficult for the clinician and therefore requires an analysis of all possible risk factors for complications development. Therefore, finding new possible ways to predict complications in reconstructive and plastic breast surgery is a relevant and priority direction.Purpose of a study: to develop a technique for preventing complications in reconstructive and plastic breast surgery.Material and methods. The results of 37 breast augmentation surgeries with T-shaped mastopexy in patients with different breast tissue density were analyzed, based on which an improved method of this operation was proposed. A comparative analysis of postoperative complications in early and late postoperative periods was carried out, and patients were surveyed before breast reconstruction and plastic surgery and 3, 6, and 12 months after plastic surgery to evaluate patient satisfaction with the outcome.Results. The analysis of the obtained data showed that breast tissue density plays a key role in choosing the tactics of breast augmentation with T-shaped mastopexy and is a predictor of complications development in the postoperative period.Conclusion. The planning of breast augmentation with T-shaped mastopexy should be carried out taking into account the determination of a patient's breast tissue density, which can affect the reduction of the risk of surgical complications during the surgery and in the postoperative period. The use of mastopexy technique with a preliminary marking of incisions with a margin of 1 cm to the central line from the classical V-shaped marking line is expedient in the presence of dense breast tissue in the patient.