Simultaneous Contralateral Breast Reduction with Breast Reconstruction Using DIEP/SIEA Flap

Abstract

The low abdominal adipose tissue is the first choice for autologous tissue transplantation for breast reconstruction in term of tissue volume, size and softness. Although the hyperplastic breasts are not common in Asian women, it remains a challenge for the plastic surgeons to reconstruct a symmetric and pleasing breast for some patients with hyperplastic contralateral breast. Between 2000 March and April 2005, there were consecutive 7 patients with hyperplastic contralateral breast underwent breast reduction. Two patients received breast reconstruction at separate stage from the breast reconstruction. Four of 5 patients received simultaneous contralateral breast reduction with DIEP flaps for breast reconstruction, and one patient with SIEA flap, respectively. The average age of 5 simultaneous contralateral breast reduction patients was 48 years(ranged 38-67 years). All 5 breast reconstructions were delay reconstruction. Four DIEP flaps and one SIEA flap were successful. The contralateral breast reduction went well without partial chest wall flap loss, and infection. The average operation time was 10.5 hours(ranged from 9 to 12 hours). At a mean 21-months(ranged 3-36 months)of follow-up, the contralateral reduced breast presented a pleasing shape and symmetric to the reconstructed breast using DIEP flap or SIEA flap. Four patients wear with Cup C bra and one with Cup D bra. Two of 5 patients presented with hypertrophic scars at both the reduced and reconstructed breasts, that were acceptable by the patients. The aesthetic satisfaction was on excellent score in 5 patients. In summary, simultaneous contralateral breast reduction may provide functional and aesthetic achievement for hyperplastic breast as well as minimal donor site morbidity in the breast reconstruction using DIEP or SIEA flap. Although these procedures may prolong the operation time and require the microsurgical techniques, the preliminary results of simultaneous breast reduction in breast reconstruction are promising.