Skin-Reducing Mastectomy: Dermal Sling

Abstract

A generalized lack of evidence is associated to mastectomies and reconstructions with dermal flaps. However these technique may warrant good cosmetic results in women with macromastia who can benefit from contralateral adjustment with symmetrical scarring. When performing DTI (direct to implant) breast reconstructions, the complication rates may be rather high with skin necrosis especially at the junction of the inverted T. For this reason a two-stage breast reconstruction would be advisable especially for patients at high risk (smokers, overweight, diabetic). Nipple preservation is related to the nipple to sternal notch distance. For more than 24 cm, a preservation on a double pedicle could be performed safely with few necrotic complications and predictable final results. When the nipple to sternal notch is higher than 29 cm, nipple saving is not recommended as a standard.