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Journal of the Korean Society for Aesthetic Plastic Surgery 2008;14(2):120-125.
Published online September 1, 2008.
Use of Submuscular-Subcutaneous Pocket in Immediate Prosthetic Breast Reconstruction for the Realization of Natural Ptotic Breast.
Jae Ho Jeong, Seung Kyu Shin, Jun Ho Lee, Jae Won Choi
Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Korea. jhjeong@med.yu.ac.kr
One-stage breast reconstruction with implant is the most popular method for the breast reconstruction. Since most of the implant is inserted into submuscular pocket, displacement of implant and loss of ptosis are inevitable, because of narrow space of submuscular pocket. Therefore, submuscular-subcutaneous pocket has been introduced to reproduce natural ptotic breast and we have experienced complication of "bottom-out" of implant. To prevent this complication, supportive surgical brassiere was applied. After subcutaneous mastectomy, the undermining of the pocket was submuscular in its upper part and subcutaneous in the lower part of the breast. The muscle was released inferiorly from the origin, and the detached pectoralis muscle was sutured to the subcutaneous tissue of skin flap. Supportive surgical brassiere postoperatively maintained for 3 months. From June of 2006 through May of 2007, 30 subcutaneous mastectomies combined with breast reconstruction were performed in 29 patients. The reconstructed breasts appeared satisfactorily ptotic. Nevertheless, there were short term complications such as infection (2 cases) and wound dehiscence (1 case). Capsular contracture occurred in 6 patients. We suggest the submuscular-subcutaneous pocket technique combined with postoperative supportive surgical brassiere as a simple and reliable method of breast reconstruction for realization of natural ptotic breast.
Key Words: Breast implants, Breast, Mammaplasty / Breast reconstruction, Submuscular-subcutaneous plane, Supportive surgical brassiere
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