title: An improved technique for immediate retropectoral reconstruction after subcutaneous mastectomy.
abstract: Subcutaneous mastectomy is becoming an operation of choice in certain cases of premalignant and other breast pathology. We describe a technique for simultaneous subcutaneous mastectomy and retropectoral implantation of a silicone prosthesis. Gentle blunt prepectoral, retromammary dissection is performed through an axillary incision as far inferiorly as the inframammary fold, where a fibrous bridge between the anterior surface of the pectoralis major muscle and the skin prevents dissection any lower. Through the same incision, the retropectoral space is dissected to about 5 cm below the inframammary fold. A second incision is made in the inframammary fold to join the retromammary plane of the first dissection. The gland is then dissected subcutaneously and removed through the inframammary incision. A silicone implant is introduced retropectorally through the axillary incision, thus avoiding splitting the pectoralis major. Satisfactory results have been obtained in 23 bilateral and 14 unilateral cases; it is important that the dissection be performed carefully in order to prevent the implant from riding up too high in its musculoaponeurotic sling.
mesh_terms: D001940:Breast / Q000033:anatomy & histology / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods*; D010369:Pectoralis Muscles / Q000033:anatomy & histology / Q000601:surgery*; D019736:Prostheses and Implants; D012826:Silicone Elastomers
chemical_list: D012826:Silicone Elastomers