A comparative study of envelope mastectomy and immediate reconstruction (EMIR) with standard latissimus dorsi immediate breast reconstruction.
BACKGROUND
Latissimus dorsi breast reconstruction has problems with scars at the donor site and on the reconstructed breast. We report the feasibility and aesthetic results of Envelope Mastectomy and Immediate Reconstruction (EMIR), which utilises a single lateral mammary fold incision.


METHODS
Between 2001 and 2002, 20 EMIRs were performed in 19 patients, one as a staged bilateral procedure. Twenty consecutive patients, matched for body habitus, who had undergone standard latissimus dorsi breast reconstruction by the same surgeon from 1996 to 2000 were used as controls. Patient satisfaction was assessed using a validated Body Image Scale. Standard post-operative photographs were scored by three independent observers.


RESULTS
Length of stay and complication rates were equivalent between both groups. Cosmetic self-assessment scores on the Body Image Scale and scores by the independent observers were satisfactory for both groups but no statistically significant difference was observed between groups.


CONCLUSIONS
EMIR is a technically feasible and cosmetically acceptable method of immediate breast reconstruction.
Breast Unit, Department of General Surgery, Frimley Park Hospital, Portsmouth Road, Camberley, Surrey GU16 5UJ, UK. andrew.hayes@rmh.nthames.nhs.uk
A J
AJ
Hayes
J P
JP
Garner
W
W
Nicholas
I J
IJ
Laidlaw
D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015414:Mastectomy, Subcutaneous / Q000379:methods*; D008499:Medical Records; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D016896:Treatment Outcome