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Novel 3-D Imaging Analysis of the Ryan Procedure for Inframammary Fold Elevation in the Reconstruction of the Revised Breast
Casey T. Kraft, MD, Juan L. Rendon, MD, PhD, Cynthia A. Koutz, MS, PA-C, and Michael J. Miller, MD
The Ohio State University Wexner Medical Center
2017-01-30
Presenter: Casey Kraft, MD
Affidavit:
This material has not been previously presented or published. This material is the original work of Casey Kraft and his co-authors equally.
Director Name: Gregory Pearson, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction:
The Ryan procedure is an infrequently reported procedure for reconstruction and elevation of the inframammary fold in previously reconstructed breasts. This study aims to analyze results for this technique using 3-D imaging technology and assess this technique's utility for reconstruction.
Methods:
We retrospectively reviewed consecutive breast reconstruction patients by a single surgeon from January 1, 2012 to January 31, 2015 to identify patients who underwent a Ryan procedure for inframammary fold reconstruction. Previously obtained 3-D photographs for these patients were then analyzed to objectively compare breast base diameter, breast projection, and inter-inframammary fold distance pre- and post-operatively. Length of follow up was also recorded.
Results:
One hundred ninety five consecutive patients were reviewed, 14 patients were found to have Ryan procedures performed for inframammary fold reconstruction. Eight patients had pre-operative and post-operative 3-D images available for analyses. Of the patients with 3-imaging available, 50% were unilateral and 50% were bilateral reconstructions. The Ryan procedure resulted in successful inframammary fold reconstruction with an inter-inframmary fold discrepancy reduction of 39% and a breast projection increase of 18%. Average length of follow up was 1028 ± 274 days, with durable reconstruction throughout this time. Base diameter between breasts remained stable pre- and post-operatively. Only one patient required a secondary IMF revision.
Conclusions:
3-D imaging provides a useful approach in the objective assessment of breast reconstruction outcomes. Herein, we objectively demonstrate that the Ryan procedure remains a reliable technique for inframammary fold reconstruction during secondary breast reconstruction surgery.
