Purpose:

The purpose of this study is to present different scenarios of skin management in immediate, autologous breast reconstruction following skin-sparing mastectomy.

Materials&Methods:

Three groups of patients who have had immediate autologous breast reconstruction are examined. Cases where the ideal periareolar scar have been achieved are presented, and which closure techniques can be used to obtain optimum breast shape while minimizing the resulting scar. The second group of patients consist of those who have a skin deficit, while the third group are those who have excess skin where mastopexy techniques are needed.

Conclusions:

A periareolar incision can be used to remove the nipple-areola complex and the breast parenchyma, and this incision may be modified depending on existing biopsy scars. At reconstruction, a paucity of skin or an excess of skin may be faced depending on the size of the breast, the size and shape of the opposite breast, and the volume desires of the patient. Because of these limitations, vertical extensions of the scar, keyhole incisions, “tailor-tacking” of excess skin, or inverted T incisions may be needed to achieve a satisfactory result. This study identifies techniques which may be used to achieve an ideal reconstructed breast.