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Kiya Movassaghi
Oregon Health and Science University, USA
Keynote: Surg Case Rep
Acellular dermal matrix (ADM) has become a perceived integral aspect of breast reconstruction over the past decade. It is commonly placed as a sling between the inferior edge of the pectoralis muscle and inframammary fold to provide support and prevent “window-shading” of the pectoralis muscle, or as a version of a wrap in the prepectoral pocket. Advocates of ADM propose it provides an aesthetically superior breast shape by controlling implant position. It has been proposed that the ADM also provides improved thickness, along with fat grafting, for more optimal implant coverage, described by Maxwell as a “bioengineered breast”. They also suggest it improves tissue expansion dynamics which allows shorter expansion times and possibly quicker progression through the reconstruction. The downsides of ADM include possibly higher rates of major infections, seromas, reconstructive failures, and cost. In our study, we use P4HB for lateral pocket control and implant support in immediate two stage pre-pectoral breast reconstruction. Classically large, ptotic breasts have been a contraindication for nipple preservation during breast reconstruction. We have developed an algorithmic approach in managing the skin envelop. For the very ptotic breast, we have described a novel technique of “Smile Mastopexy” to address some of these issues. This reduces the excess skin in both vertical and transverse directions, avoids a “T-junction”, preserves the nipple areolar complex, and adds thickness to the upper pole of the breast at the time of mastectomy. In addition, it allows future skin envelope management in the form “full snitch” or “half snitch” via the preexisting scars.
Recent Publications:
1. Movassaghi, Kiya. et.al (2021). Shaping the Breast A Comprehensive Approach in Augmentation, Revision, and Reconstruction. DOI: 10.1007/978-3-030-59777-1.
2. Movassaghi, Kiya & Cusic, Jenna. (2021). Shaping the Breast: Optimizing Outcomes in Breast Augmentation. DOI: 10.1007/978-3-030-59777-1_1.
3. Kiya Movassaghi, MD, DMD, FACS, Christopher N Stewart, MD, The “Smile Mastopexy”: A Novel Technique to Aesthetically Address the Excess Skin Envelope in Large, Ptotic Breasts While Preserving Nipple Areolar Complex During Prosthetic Breast Reconstruction, Aesthetic Surgery Journal, Volume 42, Issue 6, June 2022, Pages NP393–NP403, https://doi. org/10.1093/asj/sjac021.
Kiya Movassaghi is a Harvard trained plastic surgeon, assistant clinical professor of plastic surgery at Oregon Health Science University, Vice President of The Aesthetic Society and director of aesthetic fellowship at Movassaghi Plastic Surgery and Ziba Medical Spa. He is an expert in plastic surgery, been a visiting professor to many universities and society meetings and has lectured on many aesthetic surgery topics. He has many paper and chapter publications and recently published a book titled “shaping the breast”. Outside of plastic surgery, he enjoys triathlon and is currently training for an IRONMAN race in July of 2022.
