Two-stage Reconstruction of the Large and Ptotic Breasts: Skin Reduction Mastectomy with Prepectoral Device Placement

Plastic and Reconstructive Surgery. Global Open
Charalambos K RammosAran Yoo

Abstract

Wise pattern skin reduction mastectomy with prepectoral placement of the device is a recent technique for reconstruction in patients with large and ptotic breasts. Expanders in the first stage, followed by implant exchange in the second stage are placed above the pectoralis major muscle, totally covered by acellular dermal matrix and an inferior dermal flap. This technique was performed on 6 breasts in 4 obese patients with macromastia and grade 2 and 3 ptosis. Two patients experienced complications at the T-junction. One patient experienced superficial skin sloughing managed conservatively. The second patient developed full-thickness necrosis treated with excision and primary closure. No implant loss occurred. All patients were exchanged in a second stage to an implant, and 2 of them had symmetry procedures, with good cosmetic results. Larger, long-term studies are required to further characterize results and define the limitations of this newer surgical technique.

References

Aug 26, 2006·Plastic and Reconstructive Surgery·Maurizio B NavaGuidubaldo Querci Della Rovere
Jan 8, 2013·Annals of Surgical Innovation and Research·Geoffrey C GurtnerMichael R Zenn
May 25, 2016·Plastic and Reconstructive Surgery·Glenda Giorgia CaputoMaurizio Governa
Feb 6, 2017·Aesthetic Surgery Journal·Hilton Becker, Nicole Fregosi
Apr 16, 2017·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Jason CorbanOmar Fouda-Neel
Nov 23, 2017·Plastic and Reconstructive Surgery·Allen Gabriel, G Patrick Maxwell
Nov 23, 2017·Plastic and Reconstructive Surgery·Maurice Y Nahabedian, Costanza Cocilovo
Nov 23, 2017·Plastic and Reconstructive Surgery·Glyn JonesEric Elwood

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Citations

Dec 18, 2018·Journal of Plastic Surgery and Hand Surgery·Emma HanssonHåkan Hallberg
Dec 20, 2019·Annals of Plastic Surgery·Oscar J ManriqueNho V Tran

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