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Application of the No-Vertical Scar Technique for Oncoplastic Breast Reduction
Julia A. Cook, MD; Sarah E. Sasor, MD; Will DeBrock, BS; Ivan Hadad, MD; Aladdin H. Hassanein, MD, MMSC
Indiana University School of Medicine
2019-01-18
Presenter: Julia A. Cook, MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: William A. Wooden, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
INTRODUCTION: Breast conserving therapy (BCT) is most commonly performed with a Wise pattern skin excision and an inferior pedicle; however, patients may have an elevated risk of nipple loss if they have a long sternal notch to nipple (SNN) distance. The Boston Modification of the Robertson no-vertical scar Technique (BMRT) has been proposed as a technique to reduce this risk in ptotic breasts. The purpose of this study is to assess outcomes of the BMRT for oncoplastic reduction.
METHODS: Patients undergoing oncoplastic breast reduction using the BMRT between 2017-2018 were analyzed. Patient demographics, comorbidities, notch to nipple distance, tumor size, lumpectomy weight, margin status, and surgical complications were studied. The technique comprises using an apron flap draped over a wide, bell-shaped inferior pedicle and results in an IMF scar without a vertical component.
RESULTS: 7 patients who had BMRT oncoplastic reductions were included. Average age was 56.0 ±8.6 years. Average BMI was 39.8 ±6.8 kg/m2. The mean SNN distance was 36.0 cm (range 32-40cm). Two patients (28.6%) were smokers, 2 patients had diabetes mellitus, and 4 patients (57.1%) had hypertension. Five tumors were located in the upper lateral quadrant; two were in the upper medial quadrant. Four patients experienced minor delayed wound healing, and one had a post-operative seroma. No patient required free nipple grafts or had nipple necrosis.
CONCLUSION: The BMRT is useful when applied for oncoplastic reduction of large, ptotic breasts. This technique can be used to avoid the need for free nipple grafts in high risk patients.
