The versatility of the inferior dermal flap in implant/expander-based immediate breast reconstruction and its application in augmentation–mastopexy

Abstract

The inferior dermal flap technique with the Wise pattern skin resection has been used in the authors practice, mainly in patients who required bilateral or unilateral risk-reducing mastectomy for prophylaxis. The versatility of this procedure allowed the senior authors (MPS and PL) to extend its applicability for vertical scar augmentation–mastopexy in asymmetrical breast and for Wise pattern skin resection mastopexy–augmentation in massive weight loss. Between 2006 and 2009, the inferior dermal flap was performed in 18 patients with a total of 34 breasts, 20 of which had the Wise pattern skin resection following risk-reducing mastectomy, two of which were unilateral, six had a Wise pattern skin resection after massive weight loss and six had a vertical skin excision for asymmetrical breasts. No haematoma, infection or seroma were seen with this technique. No breakdown at the T junction was reported. One patient had a capsular contracture which required a capsulectomy and replacement of implants. We report our experience of this technique in patients undergoing unilateral skin-reducing mastectomies for prophylaxis and we demonstrate the versatility of the dermal flap when applied for vertical scar augmentation–mastopexy in the asymmetrical breast and for Wise pattern skin resection mastopexy–augmentation in massive weight loss.