Skip to main content
Top
Published in: Indian Journal of Surgery 1/2023

21-03-2022 | Mastectomy | Surgical Techniques and Innovations

A Modification of the Standard Grisotti Flap

Authors: Ashok Basur Chandrappa, Harish Kumar Kabilan, Dinkar Sreekumar, Annika Marwah, Somashekar S. P., Shabeer Zaveri

Published in: Indian Journal of Surgery | Issue 1/2023

Login to get access

Abstract

The inception of breast conservation surgery together with advances in oncoplastic techniques has transformed the management of retro areolar breast tumours. Cancers in this location were conventionally managed with central excision and primary closure or mastectomy. Lately, oncoplastic breast-conserving techniques such as the Grisotti mammoplasty have been increasingly encouraged as an alternative option as it allows oncological safe margin resections while restoring cosmesis. The use of a Grisotti flap allows for safe resection of a retro areolar tumour with the simultaneous reconstruction of the defect using a local rotational advancement dermoglandular flap allowing acceptable results in terms of aesthesis, contour and projection. The most common issues with the standard Grisotti were skin puckering and NAC asymmetry.
We describe that a modification of the standard Grisotti flap is made such that it gives a fuller and ptotic lower pole appearance, avoiding both skin puckering of the tissues or skin, as well as any mismatch in the normal NAC (nipple-areola complex) size.
This study discusses Andrea Grisotti’s original advancement-rotation flap and provides a technical modification made in our breast unit that aids wound closure and may improve the final aesthetic result of this operation.
Literature
1.
go back to reference Multon O, Bourgeois D, Validire P, Vilcoq JR, Durand JC, Clough K (1997) [Breast cancers with central localization: conservative treatment by tumorectomy with ablation of the areolar plaque. [Breast cancers with central localization: conservative treatment by tumorectomy with ablation of the areolar plaque]. Presse Med 26(21):988–994PubMed Multon O, Bourgeois D, Validire P, Vilcoq JR, Durand JC, Clough K (1997) [Breast cancers with central localization: conservative treatment by tumorectomy with ablation of the areolar plaque. [Breast cancers with central localization: conservative treatment by tumorectomy with ablation of the areolar plaque]. Presse Med 26(21):988–994PubMed
2.
go back to reference Rummel S, Hueman MT, Costantino N, Shriver CD, Ellsworth RE (2015) Tumour location within the breast: does tumour site have prognostic ability? Ecancermedicalscience 9:552CrossRefPubMedPubMedCentral Rummel S, Hueman MT, Costantino N, Shriver CD, Ellsworth RE (2015) Tumour location within the breast: does tumour site have prognostic ability? Ecancermedicalscience 9:552CrossRefPubMedPubMedCentral
3.
go back to reference Schrenk P, Hall-Findlay EJ, Fitzal F, Grisotti A, Casella D, Calabrese C, et al. OPS and Breast Conserving Surgery (BSC). In: Fitzal F, Schrenk P, editors. Oncoplastic Breast Surgery: A Guide to Clinical Practice [Internet]. Vienna: Springer; 2010 [cited 2021 Sep 21]. p. 45–132. Available from: https://doi.org/10.1007/978-3-211-99317-0_4 Schrenk P, Hall-Findlay EJ, Fitzal F, Grisotti A, Casella D, Calabrese C, et al. OPS and Breast Conserving Surgery (BSC). In: Fitzal F, Schrenk P, editors. Oncoplastic Breast Surgery: A Guide to Clinical Practice [Internet]. Vienna: Springer; 2010 [cited 2021 Sep 21]. p. 45–132. Available from: https://​doi.​org/​10.​1007/​978-3-211-99317-0_​4
4.
go back to reference Wagner E, Schrenk P, Huemer GM, Sir A, Schreiner M, Wayand W (2007) Central quadrantectomy with resection of the nipple-areola complex compared with mastectomy in patients with retroareolar breast cancer. Breast J 13(6):557–563CrossRefPubMed Wagner E, Schrenk P, Huemer GM, Sir A, Schreiner M, Wayand W (2007) Central quadrantectomy with resection of the nipple-areola complex compared with mastectomy in patients with retroareolar breast cancer. Breast J 13(6):557–563CrossRefPubMed
5.
go back to reference Fitzal F, Nehrer G, Hoch D, Riedl O, Gutharc S, Deutinger M et al (2007) An oncoplastic procedure for central and medio-cranial breast cancer. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 33(10):1158–1163 Fitzal F, Nehrer G, Hoch D, Riedl O, Gutharc S, Deutinger M et al (2007) An oncoplastic procedure for central and medio-cranial breast cancer. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 33(10):1158–1163
7.
go back to reference A G, Casella D, Calabrese C. Grisotti A, D.Casella, C.Calabrese. Immediate Reconstruction of Central Quadrantectomy Defects with a Rotation Flap - The Grisotti Technique. In: Florian Fitzal and Peter Schrenk Oncoplastic Breast Surgery: A Guide to Clinical Practice, Springer - Verlag, Wien 2010, chapter 2.1.1.7, pp.97–100; In 2010. A G, Casella D, Calabrese C. Grisotti A, D.Casella, C.Calabrese. Immediate Reconstruction of Central Quadrantectomy Defects with a Rotation Flap - The Grisotti Technique. In: Florian Fitzal and Peter Schrenk Oncoplastic Breast Surgery: A Guide to Clinical Practice, Springer - Verlag, Wien 2010, chapter 2.1.1.7, pp.97–100; In 2010.
8.
go back to reference Johnson M, Cook L, Rapisarda FI, Betal D, Bonomi R (2020) Oncoplastic breast surgery technique for retroareolar breast cancer: a technical modification of the Grisotti flap in patients with short nipple to inferior mammary crease distance. J Surg Case Rep 2020(9):rjaa285CrossRefPubMedPubMedCentral Johnson M, Cook L, Rapisarda FI, Betal D, Bonomi R (2020) Oncoplastic breast surgery technique for retroareolar breast cancer: a technical modification of the Grisotti flap in patients with short nipple to inferior mammary crease distance. J Surg Case Rep 2020(9):rjaa285CrossRefPubMedPubMedCentral
9.
go back to reference dellaRovere GQ, Pillarisetti RR, Bonomi R, Benson J (2007) Oncoplastic surgery for retro areolar breast cancer — a technical modification of the Grisotti flap. Indian J Surg 69(4):160–2CrossRef dellaRovere GQ, Pillarisetti RR, Bonomi R, Benson J (2007) Oncoplastic surgery for retro areolar breast cancer — a technical modification of the Grisotti flap. Indian J Surg 69(4):160–2CrossRef
Metadata
Title
A Modification of the Standard Grisotti Flap
Authors
Ashok Basur Chandrappa
Harish Kumar Kabilan
Dinkar Sreekumar
Annika Marwah
Somashekar S. P.
Shabeer Zaveri
Publication date
21-03-2022
Publisher
Springer India
Published in
Indian Journal of Surgery / Issue 1/2023
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-022-03362-y

Other articles of this Issue 1/2023

Indian Journal of Surgery 1/2023 Go to the issue
Webinar | 06-02-2024 | 20:00 (CET)

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by: Viatris

Developed by: Springer Healthcare