Background and Objective

The increasing number of previously augmented patients undergoing a mastectomy and the special features of these patients requires the use of a specific approach for breast reconstruction in this setting.

We present our experience with the following capsuloplasty technique, achieving total coverage of the implant using the previously formed capsule, in previously subpectoral augmented patients undergoing skin-sparing mastectomy and immediate reconstruction.

Methods

From December 2014 to February 2016 we performed our technique in selected previously augmented patients who underwent a skin-sparing mastectomy. We excluded those patients having the implants for less than a year, subglandular placement, capsular contracture grades III and IV, broken implants, smoker patients and those who were going to receive radiotherapy. The minimum follow-up period was 1 year. We measured the aesthetic result and complications such as capsular contracture, seroma, hematoma and infection.

The skin-sparing mastectomy must preserve periprosthetic capsule. The lower pole of the new implant will be covered with the previously folded retropectoral capsule and the superior pole with the pectoralis major.

Results

Four patients were selected, mean age was 44 year-old, and mean volume of the new implant placed was 410cc. After the follow-up period (mean of 17 months) no patient suffered any major complications and no capsular contracture was identified, achieving satisfactory aesthetic results.

Conclusions

The use of a retropectoral capsular flap creates an independent plane below the subcutaneous. It is an easy and safe technique that achieves a pleasing aesthetic result. Nevertheless, we present preliminary results and more studies are needed with a longer follow-up as well as a larger number of patients to achieve more validity.

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