Skin-Reducing Mastectomy With Immediate Implant Reconstruction as an Indispensable Tool in the Provision of Oncoplastic Breast Services

Abstract

Skin-reducing mastectomy (SRM) is a method of immediate breast reconstruction derived from a Wise breast reduction incision pattern that enables immediate subpectoral implant placement after mastectomy. Its virtue lies in the manner it provides for adequate implant coverage using muscle and a deepithelialized dermal flap, thus reducing the risk of implant extrusion and providing good inframammary contour. Our experience with this technique is elaborated. Data was collected from a prospective database in our unit from January 2006 to August 2009. Information was analyzed on indications, complications, cosmetic outcomes, and recurrence rates. A total of 89 SRMs were performed in 72 patients during the study period. This included 65 SRMs for invasive breast cancer, 7 for in-situ disease, and 17 for risk reduction. Median patient age was 44 years, and follow-up ranged from 5 to 42 months. Complications included capsular contracture in 14 patients, 2 implant infections, and 1 hematoma requiring surgical evacuation. Cosmetic outcomes were graded by patients as good to excellent in 66 (92%). No local recurrences have been detected to date. Our observations support the use of this technique as a safe, valid, and useful tool in an oncoplastic breast service.