摘要

Objectives: This lecture is about implant based breast reconstruction with total submusculo-aponeurotic pocket, without using any biological materials. Introduction: As a result of the increase in breast preserving and skin sparing mastectomies, autogenous reconstructions decrease and implant based reconstructions increase. İmplant based reconstructions need well vasularised soft tissue and skin coverage. In this lecture, author's technique to obtain satisfactory aesthetic results is described. Materials / method: Preparation of total submusculo-aponeurotic pocket is described by videos. Surgical technique in reduction mastectomy is also described. Ancillary techniques, such as fat grafting, free NAC graft and prepectoral replacement are also described. Results: Patients are presented with long term results. Different surgical techniques are discussed with representative cases. Conclusion: By proper dissection of total submusculo-aponeurotic layer, satisfactory aesthetic results can be obtained without using any biological materials. Dermal flaps can be effectively used instead of them. Lower pole can be expanded effectively. Soft tissue thickness can be expanded by further fat injections. Animation problems can be solved by prepectoral replacement of the implant. Satisfactory aesthetic results can be achieved with this surgical strategy.