Extended, extended inferior pedicle and modifications of the wise pattern In onco-plastic breast reconstruction
L C J Serrurier
Netcare Breastcare Centre of Excellence, Milpark Hospital, South Africa
: J Regen Med
Abstract
Introduction: The use of reduction mammaplasty and radiotherapy to treat breast cancer, in selected cases, is an established technique, known as therapeutic mammaplasty. Therapeutic mammaplasty extends the role of breast conserving surgery, without compromising oncological goals. Materials and Methods: This study describes an adaption predominately of the inferior pedicle reduction mammoplasty. This technique is commonly used for reconstruction of the upper-pole following large volume excision in this region. This technique is an adaptation to the well-established Wise-pattern breast reduction. It reduces the volume of the breast, whilst incorporating an inferior pedicle to maintain blood supply to the nipple areola complex (or create a new NAC through the use of a skin disc). The technique has been modified by extending this pedicle further than traditionally described. It can be used to fill the parenchymal defect and provide extra skin should it be required. The maximum pedicle dimensions used in this adaptation are restricted to a 3:1 ratio. The well-established vascular integrity of the inferior pedicle allows for the extension of the pedicle, whilst restricting the length of the pedicle ensures the safety of this technique. 69 consecutive patients operated on in a 24 month period are included in this study with a mean follow up of 36 months. Results: Complications immediate and late as well at cosmetic outcome will be presented. Conclusion: This study demonstrates that this novel technique can be safely used to achieve satisfactory cosmetic outcomes especially in situations where the tumour is located in the superior pole where large excision volumes of parenchyma and skin are required.
Biography
Dr Charles Serrurier is a dedicated breast reconstructive and cosmetic plastic surgeon at the Netcare Breast Care Centre of Excellence, situated at Netcare Milpark Hospital. He is registered with the Health Professions Council of South Africa (HPCSA) as a plastic and reconstructive surgeon and is a member if the Association of Plastic and Reconstructive Surgeons of Southern Africa (APRSSA) and the International Society of Aesthetic Plastic Surgeons (ISAPS).Dr Serrurier obtained his medical degree from the University of the Witwatersrand (WITS) in Johannesburg and qualified as a plastic surgeon in 2008. Thereafter he headed the plastic surgery department at Helen Joseph Hospital for five years. During this time, he had a small private practice but concentrated on honing his breast reconstructive skills in the academic environment. Considered as one of the leading breast reconstructive surgeons in South Africa, Dr Serrurier has presented his breast reconstructive work at both local and international congresses. He remains involved with academic practice and lectures and trains plastic surgeons in advanced breast reconstruction. drcserrurier@gmail.com
