Abstract

Historically, modified radical mastectomy was the primary method of breast cancer1,2. But now a days the treatment for breast cancer has evolved, the breast conservation has been widely used3,4.But mastectomy is still the viable option for women with breast cancer5,6. In case of mastectomy choosing the optimal mastectomy incision must take into consideration the oncologic, reconstructive and aesthetic factors like preservation of nipple, mastectomy skin margins, the potential for skin involvement, mastectomy skin perfusion and viability, mastectomy skin excess, previous scars over the breast, reconstructive plan, and inconspicuous new scar placement. In the current study we aim to study the breast reconstruction aesthetics influenced by the mastectomy incision design. Methodology: The nine most commonly used mastectomy incisions were categorized into three groups: hidden scar, vertical scar, and transverse scar. Fifteen plastic surgeons blindly graded the before and after photographs of the breasts that had undergone reconstruction. The grades were given on the basis of scar visibility and position and their influence on breast aesthetics. Results: Study groups had shown statistically significant results. The modified radical mastectomies and breast reconstruction done through hidden scars give the most aesthetic results. The vertical scars are better than transverse scars. In cases of bilateral breast reconstructions the placement of scars should be symmetrical to obtain the aesthetic results. Conclusion: The mastectomy incisions play an important role in affecting the aesthetics of the breast reconstruction. The patterns take from the cosmetic breast surgery provide highly aesthetic results consistently. Every case is different thus the surgeon must consider the oncological factors and patient characteristics in choosing the ideal incision for the case.

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