Abstract
Introduction: Contouring the breast shape is one of the most time-consuming procedures in autologous breast reconstruction. We conventionally shape the breast during the last part of the operation through two separate procedures: envelope formation and flap volume adjustment. We performed envelope formation before the vascular anastomosis as predictive contouring, and were able to shorten the operation time.
Methods : The time from the end of vascular anastomosis to the end of the operation was measured as the contouring time in 236 autologous breast reconstruction procedures between June 2008 and October 2017. The predictive contouring group and the non- predictive contouring group were compared.
Results : The breast-shaping time was a median of 244 min in 42 in the non-predictive contouring group and a median of 170 min in 9 in the predictive contouring group for one-stage reconstruction (p<0.01), and a median of 234 min in 39 in the non-predictive contouring group and a median of 137 min in 27 in the predictive contouring group for second-stage reconstruction (p<0.01).
Conclusion : Predictive contouring can shorten the operation time. A free operative field can be obtained irrespective of anastomosed vessels, which allows for simultaneous flap elevation and envelope preparation.
