Sensory restoration of breast reconstruction – The search for the ideal approach continues

Zhou, Anna; Dučić, Ivica; Momeni, Arash

doi:10.1002/jso.25223

Cited by 26 publications

(23 citation statements)

References 70 publications

(239 reference statements)

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“…One systematic review and four literature reviews have examined existing publications on breast sensation following implant-based and autologous reconstruction, with and without neurotization. 5,[12][13][14][15] Although these reviews reported that breast sensation after autologous reconstruction is likely superior, 5,12 this conclusion is inconsistent with findings of subsequently published studies. 16,17 A common challenge in breast sensation research is the difficulty to effectively interpret and synthesize published data because of different methods of evaluating breast sensation, and inconsistency in the timing of evaluation.…”

mentioning

confidence: 98%

Comparing Breast Sensation between Alloplastic and Autologous Breast Reconstruction Patients Using the BREAST-Q Sensation Module

Voineskos

Olaiya

Tsangaris

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Sensory recovery of the breast is a compelling frontier in comprehensive postmastectomy breast reconstruction. This study uses the BREAST-Q Sensation Module to evaluate the differences in women who underwent an alloplastic versus autologous breast reconstruction. Methods: Women with a history of breast cancer and postmastectomy breast reconstruction were recruited through the Love Research Army, United States. Participants completed the BREAST-Q Sensation Module, which consists of three scales: Breast Symptoms, Breast Sensation, and Quality of Life Impact. Descriptive statistics and multiple linear regression analyses were used to compare outcomes between women undergoing alloplastic or autologous breast reconstruction. Results: Of 1204 respondents, 933 were included for analysis: 620 (66.5 percent) underwent alloplastic reconstruction and 313 (33.5 percent) underwent autologous reconstruction. The average age and body mass index were 59.2 ± 10.1 years and 26 ± 5 kg/m2, respectively. Autologous reconstruction patients scored an average of 6.1 points (95 percent CI, 3.9 to 8.4; p < 0.001) and 5.3 points (95 percent CI, 2.5 to 8.1; p = 0.001) higher on the Breast Symptoms and Quality of Life Impact scales, respectively. No difference (0.0 points, 95 percent CI, −2.9 to 3.0; p = 0.75) was observed for the Breast Sensation scale. Increased time since reconstruction had a positive impact on Breast Symptoms scale scores. Radiotherapy negatively affected scores on both Breast Symptoms and Quality of Life Impact scales. Conclusions: Autologous breast reconstruction may be associated with fewer abnormal breast sensations and better sensation-related quality of life in comparison to alloplastic reconstruction. This information can be incorporated during preoperative patient counseling when discussing reconstructive options.

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mentioning

confidence: 98%

Comparing Breast Sensation between Alloplastic and Autologous Breast Reconstruction Patients Using the BREAST-Q Sensation Module

Voineskos

Olaiya

Tsangaris

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…The goals for modern breast reconstruction are best summarized by the eponym “5S,” that is, reconstruction of breasts of adequate size, shape, symmetry, softness, and sensation. 16 , 17 As techniques in the field continue to advance, we find increasing success in achieving these reconstructive goals, especially in autologous reconstruction. 18 However, a commonly overlooked element is the aesthetic appearance of the abdomen following surgery.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Flap-based Breast Reconstruction versus Abdominoplasty: The Impact of Surgical Procedure on Scar Location

Momeni

2020

Plastic and Reconstructive Surgery - Global Open

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Background: Autologous breast reconstruction has been demonstrated to be associated with superior patient-reported outcomes, and hence is regarded as the gold standard reconstructive modality. A common drawback of this procedure, however, is related to a high abdominal scar. Recently, hybrid breast reconstruction (ie, the combination of autologous and implant-based reconstruction) was presented as an approach that would combine the benefits of both reconstructive modalities. In this study, we sought to assess abdominal aesthetic outcomes associated with this approach. Methods: Thirty-two blinded reviewers evaluated standardized pre- and postoperative abdominal images of patients following autologous reconstruction with free abdominal flap (Group 1; N = 10), hybrid reconstruction (Group 2; N = 5), and abdominoplasty (Group 3; N = 10). Aesthetic abdominal appearance, including overall result, scar position, skin redundancy, and lateral abdominal contour, was rated on a 5-point Likert scale and a comparative analysis was performed. Results: Hybrid reconstruction was associated with significantly lower abdominal scars compared with Group 1 (P = 0.01), nearing results of patients in Group 3 (P = 0.39). Significantly higher aesthetic ratings were ascribed to Groups 2 and 3 when compared with Group 1 (P < 0.001) with regard to scar positioning (P < 0.001), skin redundancy (P < 0.001), and lateral abdominal contour (P < 0.001). No significant difference in aesthetic ratings was noted between Groups 2 and 3. Conclusions: When applied to the appropriate patient population, hybrid breast reconstruction is a powerful method to achieve reconstructive goals while optimizing abdominal aesthetics. A significantly lower scar position was noted and higher abdominal aesthetic ratings were given following abdominoplasty and hybrid reconstruction compared with conventional abdominal flap-based reconstruction.

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“…Advances in breast preservation and reconstruction (including skin-sparing, nipple-sparing, deep inferior epigastric artery perforate, and neurotization techniques) aim to better preserve breast sensation to touch. However, these procedures typically have strict eligibility criteria, sensation outcomes are highly unpredictable, and normal breast sensation is rarely preserved (Magarakis et al, 2013;Zhou et al, 2018). Although surgical innovation continues to evolve (Peled and Peled, 2019), preservation of the distal branches of the intercostal nerves supplying the breast is typically infeasible for women with breast cancer due to concern about oncologic safety (Liebig et al, 2009).…”

Section: The Role Of Breast Sensation In Female Sexual Functionmentioning

confidence: 99%

Using Bionics to Restore Sensation to Reconstructed Breasts

Lindau

Bensmaı̈a

2020

Front. Neurorobot.

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Mastectomy often leads to a complete desensitization of the chest, which in turn can give rise to diminished sexual function and to disembodiment of the breasts. One approach to mitigate the sensory consequences of mastectomy is to leverage technology that has been developed for the restoration of sensation in bionic hands. Specifically, sensors embedded under the skin of the nipple-areolar complex can be used to detect touches. The output of the sensors then drives electrical stimulation of the residual intercostal nerves, delivered through chronically implanted electrode arrays, thereby eliciting tactile sensations experienced on the nipple-areolar complex. The hope is that the bionic breast will restore a woman's sense that her breast belongs to her body so she can experience the pleasure of an embrace and derive the benefit of the sensual touch of her partner.

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Sensory restoration of breast reconstruction – The search for the ideal approach continues

Cited by 26 publications

References 70 publications

Comparing Breast Sensation between Alloplastic and Autologous Breast Reconstruction Patients Using the BREAST-Q Sensation Module

Comparing Breast Sensation between Alloplastic and Autologous Breast Reconstruction Patients Using the BREAST-Q Sensation Module

Abdominal Flap-based Breast Reconstruction versus Abdominoplasty: The Impact of Surgical Procedure on Scar Location

Using Bionics to Restore Sensation to Reconstructed Breasts

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