Adolescent Burned Breast Reconstruction



Adolescent Burned Breast Reconstruction


David A. Billmire

Kim A. Bjorklund





PATHOGENESIS



  • With the onset of puberty, the breast bud will begin to grow and expand the overlying skin acting much like a tissue expander.4


  • Any overlying scar can cause restriction and/or distortion of the maturing breast mound.


  • Additionally, full-thickness tissue loss from the burn injury surrounding the breast bud will cause additional loss in the eventual volume of the breast.


  • Complete loss of the breast bud itself will result in a smaller or absent breast.


  • Burn wounds may also result in the loss of the nipple areolar complex, despite the development of an acceptable breast mound.


NATURAL HISTORY



  • Full-thickness and deep second-degree burn injuries to the female chest warrant special care in the acute burn wound and careful management in the subsequent time period prior to development of the breast.3,4,5


  • Care should be taken with axillary releases, especially when considering the use of Z-plasties. An inappropriately designed Z-plasty can unknowingly transpose the breast bud into the axilla.


  • As the breast develops, the amount of constriction and distortion will become apparent.


  • It is advisable to delay release/reconstruction until the breast has reached its full size.


  • Rarely, the release may be warranted prior to growth completion and will most likely need to be repeated.


PATIENT HISTORY AND PHYSICAL FINDINGS

Feb 27, 2020 | Posted by in Pediatric plastic surgery | Comments Off on Adolescent Burned Breast Reconstruction
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