title: Skin-reducing mastectomy with immediate implant reconstruction as an indispensable tool in the provision of oncoplastic breast services.
abstract: BACKGROUND
  Skin-reducing mastectomy (SRM) is a method of immediate breast reconstruction derived from a Wise breast reduction incision pattern that enables immediate subpectoral implant placement after mastectomy. Its virtue lies in the manner it provides for adequate implant coverage using muscle and a deepithelialized dermal flap, thus reducing the risk of implant extrusion and providing good inframammary contour. Our experience with this technique is elaborated.
  
  
  METHODS
  Data was collected from a prospective database in our unit from January 2006 to August 2009. Information was analyzed on indications, complications, cosmetic outcomes, and recurrence rates.
  
  
  RESULTS
  A total of 89 SRMs were performed in 72 patients during the study period. This included 65 SRMs for invasive breast cancer, 7 for in-situ disease, and 17 for risk reduction. Median patient age was 44 years, and follow-up ranged from 5 to 42 months. Complications included capsular contracture in 14 patients, 2 implant infections, and 1 hematoma requiring surgical evacuation. Cosmetic outcomes were graded by patients as good to excellent in 66 (92%). No local recurrences have been detected to date.
  
  
  CONCLUSIONS
  Our observations support the use of this technique as a safe, valid, and useful tool in an oncoplastic breast service.
authors.affiliation: Department of General Surgery, New Cross Hospital, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK. nair.amit@doctors.org.uk
authors.forename: Amit
authors.initials: A
authors.lastname: Nair
authors.forename: Sahila
authors.initials: S
authors.lastname: Jaleel
authors.forename: Nick
authors.initials: N
authors.lastname: Abbott
authors.forename: Pauline
authors.initials: P
authors.lastname: Buxton
authors.forename: Pilar
authors.initials: P
authors.lastname: Matey
mesh_terms: D000328:Adult; D000368:Aged; D018427:Breast Implants; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery*; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D008875:Middle Aged; D011446:Prospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult