Objectives: To describe the autoderm flap as an important technique in implant-based immediate breast reconstruction.
To describe the benefits and advantages of this technique in the absence of allograft use in breast reconstruction.
Introduction: The incidence of breast cancer is still on the rise today, with as many as one out of eight women afflicted with this disease. Over the last several decades, there has been refinements in the surgical management of breast cancer, with the advent of breast conservation surgery and oncoplastic surgery. For those opting for mastectomy, there are also areas of improvement in breast reconstruction. One of these is the use of the autoderm flap in implant-based breast reconstruction.
Materials / method: In patients with large, ptotic breasts, the autoderm flap is an ideal technique in implant-based breast reconstruction. The inferior portion of the mastectomy flap is used for additional coverage of the implant. The skin here is de-epithelialized and the dermal flap is remained attached inferiorly along the inframammary fold. This serves as additional coverage for the implant or expander, especially if there are no available allografts or dermal substitutes to cover the inferior and lateral poles. The implant is placed subpectorally, and the autoderm flap is sutured to inferior pectoralis.
Results: The autoderm flap is an inferiorly based dermal pedicle used in immediate breast reconstruction after a mastectomy. It has been shown to be very useful and reliable, especially in the absence of allografts and dermal skin substitutes for implant coverage. In large, ptotic breasts with excess skin, this technique can be used, with good results and satisfied outcomes. A contralateral breast lift or reduction can also be offered to achieve better symmetry, and this can be performed during the time of mastectomy, or in another setting.
Conclusion: The autoderm flap technique in implant-based immediate breast reconstruction is a tried and tested technique, especially for breast cancer patients with large, ptotic breasts who opt for mastectomy. The procedure is described and revisited here in detail, and the benefits, advantages, disadvantages, and risks are discussed thoroughly.
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