The burned female breast: a report on four cases

Chest wall burns in young girls create a wide variety of problems such as scars, damage of the nipple-areolar complex (NAC) and damage of the breast tissue. An absent, hypoplastic or distorted breast deformity, resulting in asymmetry of the breast adds significantly to the psychological burden of the young women. In acute burns of the breast, it is important to conserve as much of the viable tissue as possible, especially in the case of young girls. That means that the eschar around the nipple should be allowed to demarcate completely and then be excised to the viable tissue. This will favour future reconstruction by increasing possibilities [1,2]. For that reason, the individual problems of any patient must be addressed separately according to the conditions found at the time of reconstruction. Burn patterns and the patient’s expectation may effect the choice of reconstruction. This report describes our experiences with the breast reconstruction in young women who suffered burn injuries of the anterior and in one case of the whole trunk as a child. As a consequence, they all experienced abnormal breast development due to restrictive skin envelope or breast tissue damage. The case histories of the following four patients should illustrate the variability of problems and possible solutions, for example the common practice of scar release, division of contractures and subsequent repositioning of breast tissue to allow a normal breast development. We present in one case our experience with tissue expansion for breast reconstruction after a massive burn of the whole trunk and lastly describe the results after reconstruction with pedicled latissimus dorsi (LD) flap in two patients.