경희대학교
의과대학 성형외과학교실, 외과학교실*
김진영·양원용·고석환*·이두형
CLINICAL
EXPERIENCE AND LIMITATION OF THE IMMEDIATE BREAST
RECONSTRUCTION USING THE PERMANENT EXPANDER PROSTHESIS
Jin Young Kim, M.D., Won Yong Yang, M.D., Suck
Hwan Ko., M.D., Doo Hyung Lee, M.D.
Department
of Plastic and Reconstructive Surgery and Department
of General Surgery*,
College of Medicine, Kyung-hee
University, Seoul, Korea
Tissue
expansion in breast reconstruction is a invaluab]e
alternative surgical procedure. The advent of permanent
expander prosthesis eliminated a second operative
procedure for removal of the expander and replacement
with another permanent implant.
When
we consider the choice of method for breast reconstruction,
we have to take account of the extent of mastectomy,
past-medical history of the patient, timing of operation,
and patient, motivation. It ls still accepted that
autogenous breast reconstruction is the best choice
of the method? As autogenous breast reconstruction
increases in popularity, however, it requires longer
operation time, more complicated technique, and
careful attention to donor site. Autogenous breast
reconstruction. is also not good candidate for the
patients who have diabetes, vascular disease, smoking,
obesity, previous history of cesarean section, or
further pregnancy p1anning.
We
have performed 10 immediate breast reconstructions
after modified radical mastectomy using the permanent
expander prosthesis, manufactured by Mentor Corporation.
Among these cases, 8 patients underwent cesarean
section and 2 patients planned pregnancy. Although
this method has advantages of simple technique,
minimal morbidity, and low cost, it has some limitations
for oriental. First, it is inevitable in superior
fullness of the reconstructed breast because of
round shape of the expander. Second, it is difficult
to get ptotic breast because of thick and inelastic
characteristics of oriental skin. Third, the ratio
of expander base to projection is not appropriate
for orientals because of their smaller chest size.
We experienced 2 cases of spontaneous deflation
for its manufactural defect itself. In our experience,
we would like to suggest that new type of permanent
expander prosthesis should be innovated.
Key
Words : Breast reconstruction, Tissue expansion,
Permanent expander prosthesis |
