title: Breast reconstruction following prophylactic mastectomy for smaller breasts: the superiorly based pectoralis fascial flap with the Becker 35 expandable implant.
abstract: BACKGROUND
  Immediate reconstruction using tissue expander/implants following prophylactic mastectomy for smaller breasts is a reliable means of providing similar size, shape and symmetrical reconstructions. The superiorly based pectoralis fascial flap allows an immediate reconstruction of the inferior pole and may eliminate the need for tissue expansion.
  
  
  METHODS
  The superiorly based pectoralis fascial flap and implant was performed on 5 patients (10 breasts). The Becker 35 expandable implant was used in all cases and average size was 349 (range 290-400cc). Average age was 33 (range 21-43). The average BMI was 23 (range 20-26). One patient underwent further tissue expansion of the Becker 35 postoperatively. One patient developed a seroma in the abdominal fascial flap donor site that settled without the need for drainage. There were no other complications.
  
  
  CONCLUSIONS
  The superiorly based pectoralis fascial flap provides a one-stop reconstruction of the lower pole and can eliminate the need for tissue expansion in patients with small breasts.
authors.affiliation: Department of Plastic Surgery, The Christie, Wilmslow Road, Manchester M20 4BX, UK. gary.ross@christie.nhs.uk
authors.forename: G L
authors.initials: GL
authors.lastname: Ross
mesh_terms: D000328:Adult; D018427:Breast Implants; D001943:Breast Neoplasms / Q000517:prevention & control*; D003131:Combined Modality Therapy / Q000379:methods; D004954:Esthetics; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods*; D010369:Pectoralis Muscles / Q000601:surgery / Q000637:transplantation*; D011322:Primary Prevention / Q000379:methods; D018570:Risk Assessment; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult