Update on one-stage immediate breast reconstruction with definitive prosthesis after sparing mastectomies |
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Authors: | Salgarello Marzia Barone-Adesi Liliana Terribile Daniela Masetti Riccardo |
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Institution: | a Plastic Surgery Department, Catholic University of the Sacred Heart, Largo Gemelli 8, 00168 Roma, Italyb Breast Unit, Catholic University of the Sacred Heart, Largo Gemelli 8, 00168 Roma, Italy |
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Abstract: | Immediate breast reconstruction after skin and nipple-sparing mastectomies is commonly performed as a two-stage procedure; to overcome the paradox of traditional two-stage tissue expander/implant reconstruction used to create a tight muscular pocket that needs expansion to produce lower pole fullness, while losing the laxity of the mastectomy skin flaps, the authors conceived a subpectoral-subfascial pocket by elevating the major pectoral muscle in continuity with the superficial pectoralis fascia up to the inframammary fold. This alteration allowed for the immediate insertion of the definitive implant.The authors present their experience in 220 cases of immediate one-stage breast reconstructions with definitive prostheses in sparing mastectomies. Immediate and long-term local complications were evaluated. Immediate breast reconstruction with definitive anatomical silicone-filled implants can produce excellent cosmetic results (78.6%) with a low rate of complications (17.7%); these results allow for agreement between oncologic, aesthetic and economic purposes. |
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Keywords: | Skin-sparing mastectomy Nipple-sparing mastectomy Immediate breast reconstruction Implant breast reconstruction One-stage prosthetic breast reconstruction Submuscular-subfascial pocket |
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