Volume 24, Issue 105, September - October, 2020

Implant based reconstruction in large ptotic breasts

Tarek Hashem^♦, Ahmed Farahat

Breast surgery unit, National Cancer Institute, Cairo University, Egypt

^♦Corresponding author
Breast surgery unit, National Cancer Institute, Cairo University, Egypt; Email: hashimotoo@hotmail.com

ABSTRACT

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

Medical Science, 2020, 24(105), 3191-3198

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