Contralateral Breast Management Related to Breast Reconstruction in Korean Females

Abstract

Purpose: The final purpose of post mastectomy reconstruction is a balanced, symmetrical, pleasing appearance for both breasts. However, in cases where women have an unattractive breast, which may be small, ptotic or huge, remodeling of the contralateral breast may be desirable. Surgical options available for the contralateral breast included breast augmentation using implants, mastopexy, and reduction mammoplasty. Methods: All patients who underwent unilateral breast reconstruction at Kyungpook National University Hospital from September of 2006 to February of 2008 were included in this study. The methods of reconstruction included transverse rectus abdominis musculocutaneous flap, latissimus dorsi flap, and the use of implants. Contralateral procedures to achieve symmetry included augmentation, mastopexy, and reduction. Results: A total of 57 patients were evaluated, including 45 immediate, and 12 delayed reconstructions. Twenty-six of these patients underwent contralateral breast management (augmentation [12], mastopexy [11], and reduction [3]). The average age was 44.9 years and the mean follow up interval was 13 months. Most of the patients were satisfied with the symmetry, clothed appearance, nude appearance, aesthetics, and consistency. Sixtysix percent (8 of 12) of delayed reconstruction patients had a symmetry procedure performed on the opposite breast, compared with 40 percent (18 of 45) of the immediate-reconstruction patients. No complications were observed on the contralateral breasts undergoing symmetrization. Conclusion: Contralateral management in breast reconstruction can provide symmetry with the reconstructed breast contour and aesthetically satisfactory results in a safe manner. Immediate symmetrization procedure also can avoid secondary operations and offer psychological benefits without delaying adjuvant therapy.