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Related Experiment Video

Updated: Jun 23, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
13:35

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

Published on: May 17, 2024

Wise-pattern breast reconstruction: modification using AlloDerm and a vascularized dermal-subcutaneous pedicle.

Christopher A Derderian1, Nolan S Karp, Mihye Choi

  • 1Institute of Reconstructive Plastic Surgery, New York University School of Medicine, New York, NY, USA.

Annals of Plastic Surgery
|April 24, 2009
PubMed
Summary

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This study introduces a modified Wise-pattern technique for immediate breast reconstruction using AlloDerm and a dermal-subcutaneous pedicle (DSP). This approach enhances implant coverage and improves aesthetic outcomes in large-volume breast mound reconstruction.

Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Biomaterials in Medicine

Background:

  • Immediate implant-based breast reconstruction offers advantages over staged techniques.
  • Large-volume breast reconstruction using the Wise-pattern technique faces challenges with submuscular implant pocket coverage, risking T-point breakdown and implant exposure.
  • Augmenting implant coverage is crucial for successful immediate reconstruction in these cases.

Purpose of the Study:

  • To present a novel technique for Wise-pattern immediate breast reconstruction using AlloDerm and a vascularized dermal-subcutaneous pedicle (DSP).
  • To evaluate the efficacy of this technique in improving implant coverage and aesthetic results, particularly at the T-point suture lines.
  • To compare the breast symmetry outcomes with traditional two-stage reconstruction methods.

Related Experiment Videos

Last Updated: Jun 23, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
13:35

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

Published on: May 17, 2024

Main Methods:

  • A series of 20 consecutive patients with large breasts (>400 mL volume) underwent immediate implant reconstruction using the Wise-pattern technique with AlloDerm and DSP.
  • Preoperative and postoperative 3-dimensional surface scans were utilized to assess breast symmetry.
  • Patient outcomes, including T-point breakdown and need for revision surgery, were meticulously documented.

Main Results:

  • The average reconstruction volume was 458 mL.
  • T-point breakdown occurred in 5 patients (25%), all of whom healed with local wound care and excellent aesthetic results, without requiring implant removal or debridement.
  • 3D surface scan analysis showed comparable breast symmetry to a matched group undergoing two-stage reconstruction with tissue expanders.

Conclusions:

  • The modified Wise-pattern technique with AlloDerm and DSP is an effective strategy for aesthetically pleasing immediate breast implant reconstruction in large-volume breasts.
  • This technique significantly enhances the reliability of the Wise-pattern method, preserving reconstruction integrity despite T-point breakdown.
  • The aesthetic outcomes and breast symmetry achieved are comparable to those of tissue expander-based, staged reconstructions.