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Simultaneous Contralateral Breast Reduction/Mastopexy With Unilateral Breast Reconstruction Using Free Abdominal Flaps

Background:Successful breast reconstruction includes the creation of a natural breast mound in addition to achieving maximal symmetry of both breasts. This study investigated the patients' outcome and satisfaction of simultaneous contralateral balancing reduction/mastopexy with unilateral breast reconstruction using free abdominal flaps. Methods:Between March 2000 and September 2009, 22 of 288 patients underwent unilateral breast reconstructions using a free abdominal flap with simultaneous contralateral breast reduction/mastopexy (group A). The remaining 266 cases were used as the control group (group B). The ultimate cosmesis with the complete pre- and postoperative pictures was assessed. The survey for the quality of life using the Heden questionnaire was obtained from 16 patients in group A. Results:All 22 flaps survived. Two deep inferior epigastric artery perforator flaps developed venous congestion and subsequent partial flap loss. The mean flap-used weight was 568 ± 128.6 g and 486 ± 158 g in group A and B, respectively (P < 0.01). There were no complications resulted from the reduction/mastopexy. The mean reduced breast tissue was 173.6 ± 101 g (range, 85–355 g). The overall cosmetic scores in group A were higher than in the group B. Of 16 patients, 7 (43.8%) graded this technique as very advantageous and the remaining 9 patients (56.2%) as advantageous. Conclusions:Simultaneous contralateral balancing procedures including reduction/mastopexy in selected patients can be performed with unilateral breast reconstruction using free abdominal flaps with greater patient satisfaction, minimal increase in operative time, and no increase in complication rates.