Simplified skin excision pattern for skin-sparing/reducing mastectomy and direct-to-implant single-stage immediate (DISSI) breast reconstruction

Abstract

Background One-stage implant-based breast reconstruction with minimal scarring is a highly appealing option to most patients. In fact, expander/implant reconstruction accounts for nearly 70% of all breast reconstructions. We present our experience with a simplified skin-preserving/reducing excision pattern in association with immediate breast reconstruction using permanent expander or prosthesis. Methods Thirty-two patients with 45 reconstructed breasts (unilateral or bilateral) between February 2010 and March 2014 are included in this study. All implants, except for two reconstructed breasts, were placed in a dual plane. Implants used were either a permanent expander or permanent silicone prosthesis. Results Two patients developed postoperative infections requiring removal of the implants. Minor wound dehiscence without implant extrusion occurred in one breast. One breast had a late deflation of the permanent expander secondary to trauma. Another patient required postoperative revision with fat grafting to improve breast contour. Conclusions One-stage prosthetic-based immediate breast reconstruction is a safe option with gratifying outcomes provided adequate patients’ selection and enough surgeons’ expertise to perform it. Level of Evidence: Level IV, therapeutic study. © Springer-Verlag Berlin Heidelberg 2015.