How is the opposite breast managed in breast reconstruction?

Updated: Jan 10, 2020
  • Author: Mark F Deutsch, MD; Chief Editor: James Neal Long, MD, FACS  more...
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Answer

Answer

In management of the opposite breast, do not assume that any large or ptotic breast requires surgery; however, it is much easier to shape the reconstructed breast to match a breast that is neither hypertrophic nor ptotic. The surgeon's preference determines the method of reduction or mastopexy.

A retrospective study by Giordano et al indicated that in patients who undergo autologous unilateral breast reconstruction with a latissimus dorsi flap, simultaneous reduction of the contralateral breast for the purpose of breast symmetry leads to no significant differences in complications or rate of reoperation compared with delayed contralateral reduction. [15]

Occasionally, more volume is needed to match the other side. The patient may not want a contralateral reduction, or the flap may have some necrosis, requiring a partial resection. As mentioned earlier, a small implant can be placed behind the flap or a latissimus flap can be transferred to fill in the defect.


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