Keisuke Kashiwagi

The incidence of breast cancer in Japan has been gradually increasing (1, 2). Although the age at which women are most susceptible to breast cancer is lower than that for other cancers (3), the 5-year posttreatment survival rate in breast cancer is favorable in comparison to that in many other cancers. Thus, the prognosis of patients with breast cancer is relatively good. Therefore, patients’ postoperative quality of life is important, and a good aesthetic outcome after reconstruction surgery following cancer resection is a major quality -of life factor. Symmetrical appearance after breast reconstruction contributes mainly to aesthetic outcome. Some form of “touch-up” surgery is required before and/or after reconstructive surgery in order to improve breast symmetry and patient satisfaction. Touch-up surgery is normally performed on the reconstructed breast and includes repositioning the mound, augmentation with fat grafting, and reduction with liposuction. However, it is sometimes performed on the contralateral breasts and includes modifying the shape, position, and size of the contralateral breasts. Breast reconstruction is of two general types, namely autologous tissue transplantation and placement of a mammary prosthesis, which is generally a silicone implant. Autologous tissue transplantation is limited by the volume of available tissue, which is related to the patient’s body mass index (BMI). A mammary prosthesis can be adjusted to the size of the breast, but for a markedly ptotic breast, the original appearance of the breast cannot be mimicked using a mammary prosthesis. When the patient’s breasts are extremely large or ptotic, breast reconstruction can result in significantly asymmetrical appearance. When obvious asymmetry results from unilateral breast reconstruction, we apply reduction mammaplasty or mastopexy to the contralateral side as a delayed touch-up surgery. We reviewed touch-up surgeries performed at our hospital to evaluate the efficacies of reduction mammaplasty and mastopexy performed for breast symmetrization on the contralateral side.