Reconstruction of the Ptotic Breast Using Wise Pattern Skin Deepithelialization.

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Breast Reconstruction

Background:

• Skin redundancy after skin-sparing mastectomy presents challenges in breast reconstruction, particularly for ptotic or large breasts.
• Traditional skin reduction techniques, such as horizontal ellipses or Wise pattern excision, can lead to flattened breasts, conspicuous scarring, skin necrosis, and implant complications.
• Preserving the subdermal plexus is crucial for maintaining skin viability and achieving optimal aesthetic outcomes.

Purpose of the Study:

• To describe and evaluate a modified Wise pattern skin reduction technique utilizing deepithelialization for breast reconstruction.
• To assess the efficacy of preserving the subdermal plexus through deepithelialization in reducing skin redundancy.
• To determine the complication rates associated with this technique in patients undergoing simultaneous prosthetic reconstruction.

Main Methods:

• A case series involving 15 patients (26 breasts) undergoing breast reconstruction.
• Implementation of a modified Wise pattern technique where skin within the pattern was preserved but deepithelialized.
• Simultaneous prosthetic reconstruction using tissue expanders was performed in all cases.

Main Results:

• The deepithelialization technique allowed for apparent skin reduction while preserving the subdermal plexus.
• This approach aimed to mitigate risks of skin necrosis and implant exposure associated with traditional Wise pattern excision.
• Data from the case series were reviewed to evaluate the outcomes and complication profile.

Conclusions:

• Deepithelialization of the Wise pattern skin offers a viable alternative for managing skin redundancy in breast reconstruction.
• This technique potentially improves aesthetic outcomes and reduces the incidence of surgical site complications.
• Further research is warranted to validate these findings in larger patient cohorts.