Summary
Fullness in the lateral thoracic area following breast reconstruction can be a source
of concern for patients. This redundant tissue creates disharmony between the newly
reconstructed breast, the lateral mammary fold, and the lateral thoracic compartment.
In this article we present the results of our anatomical/histological study, discuss
the operative technique and present a clinical series of patients who underwent this
procedure.
Methods
Cadaveric Anatomical study: Dye injection studies on 4 hemi-chests to determine if the lateral thoracic fold
is a separate anatomic fat compartment. Tissue from the boundaries between identified
compartments was also submitted for routine H&E histological analysis.
Clinical study: Retrospective case note analysis of all patients undergoing dermolipectomy performed
by the senior author.
Results
In the analyzed cadavers, a clear line of delineation was found separating the lateral
thoracic fold from the breast and adjacent structures, this was confirmed histologically.
Forty patients underwent 64 dermolipectomy procedures. The average dimension of the
resected specimen was 13.37 cm (range 3.0–25.0 cm) × 5.44 cm (range 1.0–12.0 cm).
The mean time of dermolipectomy following initial reconstruction was 15.4 months.
As the BMI increased the average resection size increased both in length (p = 0.002) and width (p = 0.006). There were no postoperative complications.
Conclusion
The lateral thoracic fold is a distinct fat compartment. Dermolipectomy following
breast reconstruction is a useful adjunct and should be considered in any patient
with excess skin/subcutaneous tissue in the lateral thoracic region. The procedure
has a low complication rate and can be performed in conjunction with other post reconstruction
refinement procedures.
Keywords
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Article info
Publication history
Published online: October 10, 2011
Accepted:
August 19,
2011
Received:
March 15,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
