The Benefits of Partial versus Total Breast Reconstruction for Women with Macromastia

Background: Breast reconstruction following skin-sparing mastectomy in women with macromastia is challenging. Complication rates are often higher, and cosmetic results are less favorable. The study compared partial and total breast reconstruction in women with macromastia. Methods: Data were collected retrospectively on all women with macromastia and breast cancer who underwent unilateral breast reconstruction. A contralateral reduction of more than 300 g was required to be included. Comparisons were made between patients who underwent an oncoplastic reduction (group A) and those who underwent a skin-sparing mastectomy and reconstruction (group B). Results: There were 51 patients in group A and 30 patients in group B. The average contralateral reduction specimen weighed 757 g in group A and 668 g in group B. The length of stay was significantly lower in group A (0.87 versus 3.5 days). Complication rates were all lower in group A (overall, 22 versus 50 percent; breast, 22 versus 43 percent; and donor site, 0 versus 23 percent). The total number of procedures for group A was 2.4 compared with 5.8 for group B. No patients in group A required more that two trips to the operating room, compared with 53 percent of the patients in group B. Patient satisfaction with shape and symmetry was slightly higher in group A. Conclusions: Partial breast reconstruction using reduction techniques is often easier and more predictable when compared with total breast reconstruction following skin-sparing mastectomy in women with macromastia. It results in less patient morbidity, reduced length of stay, fewer operative procedures, and favorable cosmesis. (Plast. Reconstr. Surg. 125: 1051, 2010.)