Bilateral breast reconstruction with a pedicled transverse rectus abdominis myocutaneous flap after subcutaneous mastectomy for symptomatic injected breasts.
Breast deformities after augmentation with injectable materials carried out by uncertified medical personnel present challenging problems. Materials include liquid silicone, paraffin, polyacrylamide hydrogels, and unknown gels. They usually cause granulomatous reactions, erythema, pain, and even skin necrosis. Tender masses that cannot be differentiated from breast cancers are the major concern. This retrospective study presents the authors' experience in managing 10 symptomatic injected breasts in five patients during the past 8 years. Subcutaneous mastectomies were carried out using periareolar, inverted "T", or inframammary approaches combined with breast reconstruction using bilateral pedicled transverse rectus abdominis myocutaneous (TRAM) flaps. All flaps survived well and gave a satisfactory cosmetic appearance. There was no major complication or late occurrence of breast cancers over the following 8 years. Injectable materials used for breast augmentation should be prohibited until more scientific data are available about the long-term effect of these materials in breast tissues. Once the injected breasts become symptomatic, subcutaneous mastectomy and reconstruction with bilateral pedicled TRAM flaps is a reasonable option for the patient.
Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan.
Wen-Kuan
WK
Chiu
Tzu-Peng
TP
Lee
Shih-Yi
SY
Chen
Chun-Chang
CC
Li
Chih-Hsin
CH
Wang
Shyi-Gen
SG
Chen
D000180:Acrylic Resins / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D000368:Aged; D001941:Breast Diseases / Q000139:chemically induced* / Q000601:surgery*; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods*; D015414:Mastectomy, Subcutaneous; D008875:Middle Aged; D010232:Paraffin / Q000008:administration & dosage / Q000009:adverse effects; D012828:Silicones / Q000008:administration & dosage / Q000009:adverse effects; D013524:Surgical Flaps
D000180:Acrylic Resins; D012828:Silicones; C016680:polyacrylamide gels; D010232:Paraffin