Breast sharing: New perspectives on an old method

Background: Many techniques have been described for breast reconstruction after mastectomy throughout the decades. In many cases, with excess tissue being discarded, a significant reduction of the contralateral breast was needed for symmetry. Described by Marshall as a one-staged, autologous, non-microsurgical breast reconstruction technique, this method was used in perforator flaps as a breast-sharing technique.

Methods: Between June 2011 and January 2014, the breast-sharing technique was performed in seven patients with simple mastectomy, delayed breast reconstruction, and willingness for autologous non-microsurgical breast reconstruction. All the participants in this study received preoperative oncological screening with ultrasound, magnetic resonance imaging, or mammography, which revealed the absence of pathologic imaging in the donor breast.

Results: The experiences of seven patients who underwent breast reconstruction surgery through breast-sharing technique are presented. Due to venous congestion, one of the patients (14%) suffered major complications with total loss of the flap. A total of four patients (57%) incurred minor complications with little to no repercussions on the final outcome. The functional and aesthetic outcomes were very satisfactory, and only one patient required a second touch-up surgery for lipofilling due to unsatisfactory breast volume. Regular follow-ups were done by the oncologist with no recurrences found up to the present.

Conclusions: Using contralateral breast as the donor site, this article presents the first case series for one-stage mammarian reconstruction. With some complications but good aesthetic outcomes, this method has been shown as another available method for breast reconstruction in patients with hypertrophic and ptotic breast.