[One-stage reconstruction of the breast after mastectomy with skin preservation]

Our experience points to the advantages of preserving a cutaneous flap remaining after mastectomy followed by one-stage reconstruction using a recto-abdominal flap of silicone expanders and endoprostheses. The procedures used provided for removal of the halo-papillary complex, skin scarred by biopsy, the entire mammary gland tissue with the subaxillary, subclavicular and subscapular lymph nodes. The epithelium was removed from the recto-abdominal flap which was placed into a cutaneous pouch after mastectomy. A small round piece of the flap skin replaced the defect caused by halo removal. As a result, both breasts were practically symmetrical and identical in volume. When silicone implants are used, the skin pouch is filled with an expander installed under musculus pectoralis major. Since October, 1995, 26 such operations have been carried out.