One-staged silicone implant breast reconstruction following bilateral nipple-sparing prophylactic mastectomy in patients at high risk for breast cancer

摘要

Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. We have read with interest the paper by Sahin et al. [1] entitled one-staged silicone implant breast reconstruction following bilateral nipple-sparing prophylactic mastectomy in patients at high Risk for breast cancer. The authors are to be complemented for demonstrating that one-stage immediate breast reconstruction (IBR) with a prosthetic implant can be effectively and safely performed with a vertical-design skin-sparing and skin-reducing mastectomy (SSM/ SRM) contrary to earlier recommendations that only autogenous tissue reconstruction must be performed with a vertical pattern because any possible wound dehiscence of the vertical suture line would result in implant loss [2, 3]. The authors recommend extending the lateral and medial limbs of the marking to the inframammary fold (IMF). With their approach, the delineated area then is deepithelialized, after which a vertical incision is made in the midline of this area and extended to the IMF, allowing adequate access for the performance of a nipple-sparing mastectomy. A breast implant then is inserted and skin suturing is performed after the two deepithelialized flaps are folded inward [1] (Fig. la).