title: Selective capsulotomies of the expanded breast as a remodelling method in two-stage breast reconstruction.
abstract: The two-stage breast reconstruction with tissue expander and prosthesis is nowadays a common method for achieving a satisfactory appearance in selected patients who had a mastectomy, but its most common aesthetic drawback is represented by an excessive volumetric increment of the superior half of the reconstructed breast, with a convexity of the profile in that area. A possible solution to limit this effect, and to fulfil the inferior pole, may be obtained by reducing the inferior tissue resistance by means of capsulotomies. This study reports the effects of various types of capsulotomies, performed in 72 patients after removal of the mammary expander, with the aim of emphasising the convexity of the inferior mammary aspect in the expanded breast. According to each kind of desired modification, possible solutions are described. On the basis of subjective and objective evaluations, an overall high degree of satisfaction has been evidenced. The described selective capsulotomies, when properly carried out, may significantly improve the aesthetic results in two-stage reconstructed breasts, with no additional scars, with minimal risks, and with little lengthening of the surgical time.
authors.affiliation: Department of General and Specialistic Surgery, Plastic and Reconstructive Surgery Unit, Santa Maria alle Scotte Hospital, University of Siena, Siena, Italy. grimaldi@unisi.it
authors.forename: Luca
authors.initials: L
authors.lastname: Grimaldi
authors.forename: Matteo
authors.initials: M
authors.lastname: Campana
authors.forename: Cesare
authors.initials: C
authors.lastname: Brandi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nisi
authors.forename: Anna
authors.initials: A
authors.lastname: Brafa
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Calabrò
authors.forename: Carlo
authors.initials: C
authors.lastname: D'Aniello
mesh_terms: D019928:Breast Implantation; D018427:Breast Implants; D004954:Esthetics; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D017060:Patient Satisfaction; D015626:Tissue Expansion; D015625:Tissue Expansion Devices