Breast Reconstruction Breaking Paradigms

Background: With the wide acceptance of immediate reconstruction and increased cases of skin-sparing mastectomy , it is appropriate to discuss  a technique that can achieve optimal reconstruction goals with a single time initially. Radiotherapy, adjuvant treatments and others are very important to decide the type of our  reconstructions.

Methods: A total of 193  consecutive cases in 4 years. The mean patientage was 42, 6 years (range, 35 to 83 years). Although this is not the first time a single-stagetechnique with adjustable implants has been reported, it is the largest series, and thetechnique was used in all consecutive patients during  4 years who were candidates for immediate implant reconstruction. The placement of a texturized, permanently adjustable implant (Allergan Style 150) entirely submuscular ,  the use of shaping sutures initially, the careful placement of biopsy incisions, and aggressive initial debridement of mastectomy flaps are the keys to obtaining reliable results.

Results: Complications requiring major general anesthesia reoperations were capsular contracture [n  18  (9,3 percent)], and periprosthetic infection [n  6 (3,1  percent)]. Five  infected implants were salvaged and one were removed and replaced at a later date.). Aesthetic results were rated by patient and physician report to be excellent (84  percent), good (12 percent), or poor (4 percent).

Conclusions: This technique achieves the goals of providing a harmonic and simple  reconstruction in one operation without the use  flaps or complex techniques. The complication rate was low and the author discusses several methods for avoiding complications historically associated with immediate implant reconstruction.