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dc.contributor.authorBonomi, Stefano
dc.contributor.authorRicci, Cristian
dc.contributor.authorSala, Laura
dc.contributor.authorGennaro, Massimiliano
dc.contributor.authorCortinovis, Umberto
dc.identifier.citationBonomi, S. et al. 2019. Skin-reducing mastectomy and direct-to-implant breast reconstruction with submuscular-dermal-mesh pocket. Annals of plastic surgery, 82(1):19-27. []en_US
dc.identifier.issn1536-3708 (Online)
dc.description.abstractBackground Despite skin-sparing mastectomy techniques have significantly improved reconstructive options and aesthetic outcomes, patients with large and ptotic breasts remain a challenging group to treat satisfactorily. The Wise-pattern skin-reducing mastectomy (SRM) has been designed for this kind of patients but is not without morbidity. To improve safety, the authors reviewed their experience with a modified SRM and immediate 1-stage implant-based breast reconstruction, using a synthetic absorbable mesh combined with a dermal flap. Methods A retrospective review was undertaken to identify women with medium to large ptotic breast and medium minimally ptotic breast who had undergone SRM and direct-to-implant breast reconstruction using definitive anatomical gel implant, de-epithelialized dermal flap, and absorbable synthetic mesh, between October 2014 and December 2016. Patient demographics were queried, and complication rates, aesthetic outcomes, and patients satisfaction were assessed. Results Sixty-two procedures of SRM were performed in 56 patients. Forty-five women received contralateral symmetrization. Twenty-one overall complications occurred in 16 patients. Statistical correlation between risk factors and complications onset was assessed. Body mass index resulted the most substantial risk factor (P = 0.0028) for developing complications, whereas preoperative chemotherapy (P = 0.0050) and comorbidities (P = 0.0117) played a decent role. Smoking attitude (P = 0.1122), age (P = 0.9990), and implant weight (P = 0.1583) did not result as significant risk factors. The reconstructive outcomes were good to excellent in 92.8%, with patient satisfaction ranking very to highly satisfied in 84%. Conclusions The authors' series suggests that SRM with direct-to-implant breast reconstruction can be easily performed when an appropriate SRM pattern is designed, providing complete implant coverage with submuscular-dermal-mesh pocketen_US
dc.publisherWolters Kluweren_US
dc.subjectSkin-reducing mastectomyen_US
dc.subjectOne-stage implant-based breast reconstructionen_US
dc.subjectLarge ptotic breasten_US
dc.subjectDirect-to-implant breast reconstructionen_US
dc.subjectSkin-sparing mastectomyen_US
dc.subjectProphylactic mastectomyen_US
dc.titleSkin-reducing mastectomy and direct-to-implant breast reconstruction with submuscular-dermal-mesh pocketen_US
dc.contributor.researchID29790514 - Ricci, Cristian

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