Scarless Breast Reconstruction: Indications and Techniques for Optimizing Aesthetic Outcomes in Autologous Breast Reconstruction

Summary: Breast reconstruction that leaves no visible scars on the breast is possible for a subset of patients. This article reviews a cohort of 10 patients who underwent 14 autologous breast reconstructions. To achieve a reconstruction without visible breast scars, the mastectomy and autologous reconstruction are carried out through a periareolar incision. At the completion of the reconstruction, a small skin paddle is externalized through the mastectomy incision and in a subsequent stage entirely incorporated into a nipple areola reconstruction. Following completion of the breast and nipple areola reconstruction, a tattoo is performed that extends beyond the perimeter of the reconstructed areola and conceals all scars on the breast mound. The ideal candidate for this technique has a small or medium size breast, which is non- or minimally ptotic, and a donor site that can yield a flap larger than the volume of the native breast. In properly selected patients, this technique consistently yields high-quality results, which match or even surpass the aesthetics of the original breast. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Published online 14 February 2018. Received for publication October 19, 2017; accepted December 13, 2017. Disclosure: The author has no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors. Wojciech Dec, MD, Department of Plastic Surgery, Lenox Hill Hospital, 100 East 77th Street, New York, NY 10075, E-mail: drdec@drdec.com Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.

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