Journal article
The Bell Pattern: A Novel Breast Incision Approach to Skin-Reducing Mastectomies
Aesthetic surgery journal. Open forum, Vol.2(1), pp.ojz031-ojz031
10/23/2019
DOI: 10.1093/asjof/ojz031
PMCID: PMC7671254
PMID: 33791632
Abstract
Background
As immediate direct to permanent implant-based breast reconstruction (IBBR) continues to gain in popularity, surgeons seek to apply these techniques to patients with large or ptotic breasts. A new bell pattern skin excision is described and limits major complications in this high-risk population.
Objective
The authors describe a novel skin excision pattern for patients with large or ptotic breasts who desire IBBR and assess its safety. The authors also evaluated the ability of the pattern to account for intraoperative developments.
Methods
This retrospective analysis of a single surgeon’s experience included 17 consecutive patients (31 breasts) with large or ptotic breasts undergoing skin-reducing mastectomy with attempted utilization of the bell pattern approach and IBBR with acellular dermal matrix.
Results
Mean age was 50 years, mean body mass index was 27.4 kg/m2, and mean breast specimen weight was 683 g. A bell pattern excision was planned for all breasts preoperatively. Three breasts (10%) required an alternative closure pattern due to intraoperative ischemia (n = 1), or additional oncologic resection (n = 2). The pattern successfully accommodated flap ischemia in 8 (26%) other breasts. After a median follow-up of 5.1 months, the number of bell pattern breasts with major and minor complications was 0 (0%) and 9 (32%), respectively. The most common minor complication was seroma (n = 5, 18%), and minor incision wound (n = 3, 11%). There were no reconstruction failures utilizing the bell pattern.
Conclusion
The bell pattern approach is a safe and adaptable alternative to traditional skin-reducing mastectomy in patients with large or ptotic breasts.
Details
- Title: Subtitle
- The Bell Pattern: A Novel Breast Incision Approach to Skin-Reducing Mastectomies
- Creators
- William B AlbrightPatrick J Hawkes
- Resource Type
- Journal article
- Publication Details
- Aesthetic surgery journal. Open forum, Vol.2(1), pp.ojz031-ojz031
- DOI
- 10.1093/asjof/ojz031
- PMID
- 33791632
- PMCID
- PMC7671254
- NLM abbreviation
- Aesthet Surg J Open Forum
- ISSN
- 2631-4797
- eISSN
- 2631-4797
- Publisher
- Oxford University Press
- Language
- English
- Date published
- 10/23/2019
- Academic Unit
- Surgery
- Record Identifier
- 9984322908502771
Metrics
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