Immediate Breast Reconstruction after Skin-Sparing Mastectomy with the Latissimus Dorsi Flap and Low Profile Round Breast Implants. Evaluation of Results in 164 Consecutive Cases

摘要

Skin-sparing mastectomy (SSM) has become an established procedure in breast surgery with similar oncological outcome and higher aesthetic results when compared with conventional mastectomies, especially when combined with immediate autologous reconstruction. The latissimus dorsi myocutaneous flap in combination with prosthesis is a well-established procedure, mainly indicated in patients in whom the use of abdominal flaps is precluded. However, a variety of techniques has been proposed regarding latissimus dorsi management (fixation of muscle, denervation, transection of humeral insertion), implant positioning (subpectotal or not), and type of implant (anatomical or round, expander or final implant).