title: Immediate definitive prosthetic reconstruction in patients with ptotic breasts.
abstract: Immediate reconstruction of medium/large ptotic breasts can be performed by using expanders, definitive implants, or autologous flaps. If a skin-sparing mastectomy is feasible, excellent results can be achieved by planning Wise pattern incisions, using definitive implants. The authors suggest the use of a dermal-adipose flap, harvested from the ptotic part of the breast, rotated laterally, and interposed between the serratus fascia and the pectoralis muscle to close the inferolateral part of the pocket. We performed 23 immediate unilateral single-stage breast reconstructions, with simultaneous contralateral reduction. Preoperatively, all breasts showed grade II or III ptosis. There was no case of implant infection or failure of the reconstruction. The median follow-up was 21 months; however, some patients followed up for >4 years; in this period, no case of capsular contracture was observed. This technique has provided good shape, acceptable ptosis consistent with the healthy breast and symmetric scars.
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Università Cattolica del Sacro Cuore di Campobasso, Largo A. Gemelli, Campobasso, Italy. stefanogentileschi@gmail.com
authors.forename: Stefano
authors.initials: S
authors.lastname: Gentileschi
authors.forename: Roberto
authors.initials: R
authors.lastname: Bracaglia
authors.forename: Giorgia
authors.initials: G
authors.lastname: Garganese
authors.forename: Valeria
authors.initials: V
authors.lastname: Gallucci
authors.forename: Giacomo
authors.initials: G
authors.lastname: Corrado
authors.forename: Fabio
authors.initials: F
authors.lastname: Pacelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D001940:Breast / Q000601:surgery*; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D013524:Surgical Flaps