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Breast reconstruction following prophylactic mastectomy for smaller breasts: The superiorly based pectoralis fascial flap with the Becker 35 expandable implant

  • G.L. Ross
    Correspondence
    Tel.: +44 (0) 1619187054; fax: +44 (0) 1614463365.
    Affiliations
    Department of Plastic Surgery, The Christie, Wilmslow Road, Manchester M20 4BX, United Kingdom
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Published:January 11, 2012DOI:https://doi.org/10.1016/j.bjps.2011.12.016

      Summary

      Introduction

      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.

      Conclusion

      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.

      Keywords

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      References

        • Lalloo F.
        • Baildam A.
        • Brain A.
        • Hopwood P.
        • Evans D.G.
        • Howell A.
        A protocol for preventative mastectomy in women with an increased lifetime risk of breast cancer.
        Eur J Surg Oncol. 2000; 26: 711-713
        • Hopwood P.
        • Lee A.
        • Shenton A.
        • et al.
        Clinical follow-up after bilateral risk reducing (‘prophylactic’) mastectomy: mental health and body image outcomes.
        Psychooncology. 2000; 9: 462-472
        • Evans D.G.
        • Baildam A.D.
        • Anderson E.
        • et al.
        Risk reducing mastectomy: outcomes in 10 European centres.
        J Med Genet. 2009; 46: 254-258
        • Evans D.G.
        • Lalloo F.
        • Hopwood P.
        • et al.
        Surgical decisions made by 158 women with hereditary breast cancer aged <50 years.
        Eur J Surg Oncol. 2005; 31: 1112-1118
      1. McIntosh A, Shaw C, Evans G, et al. Clinical guidelines and evidence review for the classification and care of women at risk of familial breast cancer. NICE guideline CG041. London: National Collaborating Center for Primary Care/University of Sheffield; 2004 [updated 2006]. Available from: http://www.nice.org.uk.

        • Cordeiro P.G.
        • McCarthy C.M.
        A single surgeon’s 12-year experience with tissue expander/implant breast reconstruction: part I. A prospective analysis of early complications.
        Plast Reconstr Surg. 2006; 118: 825-831
        • Cordeiro P.G.
        • McCarthy C.M.
        A single surgeon’s 12-year experience with tissue expander/implant breast reconstruction: part II. An analysis of long-term complications, aesthetic outcomes, and patient satisfaction.
        Plast Reconstr Surg. 2006; 118: 832-839
        • Salzberg C.A.
        • Ashikari A.Y.
        • Koch R.M.
        • Chabner-Thompson E.
        An 8-year experience of direct-to-implant immediate breast reconstruction using human acellular dermal matrix (AlloDerm).
        Plast Reconstr Surg. 2011; 127: 514-524