One stage breast reconstruction following prophylactic mastectomy for ptotic breasts: The inferior dermal flap and implant

Introduction: Immediate reconstruction following prophylactic mastectomy for larger ptotic breasts is difficult. Tissue expansion in these patients often results in poor cosmetic outcomes. Autologous options may not be possible due to clinical unsuitability or patient choice. Using the inferior dermal flap with implant achieves lower pole fullness and allows a one-stop reconstruction in the larger ptotic breast. Methods: The inferior dermal flap and implant was performed on ten patients (20 breasts). Average age was 43 (range 36-53). The average BMI was 37 (range 32-43). The distance from nipple to IMF varied from 15 cm to 26 cm. The average implant size was 533 (range 390-620). Complications were minimal with one patient experiencing delayed wound healing at the T-junction and one patient developing inferior pole erythema postoperatively that settled with antibiotics. Conclusion: The inferior dermal flap and implant provides a one-stop reconstructive option. It is reliable, safe and maintains the breast envelope while giving excellent size, shape and symmetry in the larger ptotic patient. (C) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.