Introduction: Breast reconstruction in women with large ptotic breasts is a challenging surgical procedure. Nipple sparing
mastectomy is associated with increased surgical morbidity. Implant based reconstruction offers an attractive alternative in order to
decrease donor site morbidity. The subpectoral pocket needs support along its inferomedial aspect. This is usually provided by
acellular dermal matrix or specialized meshes. This study displays the use of a sling formed of the deepithelialised lower breast skin
flap to complete the subpectoral implant pocket. Methods: 36 patients were included in this study, all with big sized ptotic breasts.
Five patients had documented BRCA1/2 mutation and were seeking bilateral prophylactic mastectomy. 31 patients had unilateral
breast cancer and underwent unilateral Wise pattern skin reducing mastectomy. Postopoerative cosmetic results were evaluated
using the BREAST-Q™ questionnaire and the BCCT.core ©software. Results: Complications occurred in 5 (14%) patients. BREAST-Q™
results showed a median score of 73.2 for overall outcome evaluation. 55.6% of the study group had a favourable cosmetic outcome
as evaluated by the BCCT.core© software. Conclusion: The dermal sling technique provides a valid autologous alternative to acellular
dermal matrix for implant based reconstruction in patients with large ptotic breasts.
Keywords: Breast reconstruction, ptotic breasts, BCCT.core© software