title: Breast reconstruction using de-epithelialized dermal flap after vertical-pattern skin-sparing mastectomy in macromastia.
abstract: BACKGROUND
  Prophylactic mastectomy is performed to reduce the risk of breast cancer in high-risk conditions, and expectations about reconstruction are too high. Implant coverage with healthy tissue and skin reducing as an envelope are two concerns in the treatment of macromastia cases. We present our results obtained with a prosthetic reconstruction technique using an inferior pedicled de-epithelialized dermal flap after vertical-pattern skin-sparing mastectomy in this retrospective study.
  
  
  METHODS
  Fourteen patients with macromastia and with a high risk of breast malignancy were treated with breast prosthesis using an inferior pedicled de-epithelialized dermal flap after vertical-pattern skin-sparing mastectomy, and were followed for 6 months to 2 years.
  
  
  RESULTS
  Good aesthetic results were obtained in all of the patients with increased patient satisfaction. There were no serious complications and the patients were all satisfied.
  
  
  CONCLUSIONS
  Since there is no dangerous T-point in vertical-pattern skin-sparing mastectomy in contrast to an inverted-T wise-pattern technique, where flaps are connected under great tension and susceptible to separation, it can be used safely in macromastia cases, as in smaller breasts. In addition, a de-epithelialized dermal flap is quite useful to cover the inferior pole of the prosthesis and it eliminates the need for an acellular dermal matrix.
authors.affiliation: Plastic and Reconstructive Surgery, Private Practice, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Peker
authors.forename: Fuat
authors.initials: F
authors.lastname: Yuksel
authors.forename: Huseyin
authors.initials: H
authors.lastname: Karagoz
authors.forename: Sinan
authors.initials: S
authors.lastname: Ozturk
mesh_terms: D000328:Adult; D001940:Breast / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000473:pathology / Q000601:surgery*; D016462:Mammaplasty; D008408:Mastectomy; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: breast cancer; de-epithelialized dermal flap; macromastia; skin-reducing mastectomy; skin-sparing mastectomy