Breast reconstruction in the era of aesthetic surgery: Aesthetic and oncologic outcomes of direct-to-implant breast reconstruction and contralateral augmentation in breast cancer at Vietnam National Cancer Hospital.

INTRODUCTION

Asian women, including Vietnamese, generally have smaller breast volumes than Europeans. Breast-conserving surgery or unilateral reconstruction often results in contour deformities and poor symmetry in patients with small breasts. Therefore, they may require not only breast reconstruction but also contralateral augmentation to achieve optimal symmetry. Previously, surgery was typically performed in two stages, increasing both cost and treatment time for patients. In this study, we report the outcomes of direct-to-implant (DTI) breast reconstruction with simultaneous contralateral augmentation.

METHODOLOGY: This is a prospective observational study on 60 breast cancer patients undergoing skin-sparing or nipple-sparing mastectomy (SSM/NSM) with DTI reconstruction and simultaneous contralateral augmentation from January 2019 to January 2024. Data on patient characteristics, disease stage, surgical techniques, complications, aesthetic and oncologic outcomes were collected.

RESULTS

The mean age was 40.4±7.5 years. Most patients had a BMI <25 (86.7%) and small breast volume. Over a median follow-up of 25.7 months (range, 14-59 months), complications occurred in 11 patients (18.3%), including 10 related with the reconstructive implant and 1 with the contralateral augmentation. 1 patient (1.7%) developed local recurrence, and another (1.7%) presented with liver metastasis. No deaths were reported. Aesthetic outcomes were rated as "good" to "excellent" in 75% of cases at 12 months.

CONCLUSION

Direct-to-implant reconstruction with simultaneous contralateral augmentation can be safely performed in breast cancer patients with small breast volume, showing low complication rates and favorable aesthetic outcomes.