Skin-Sparing Mastectomy and Immediate Implant Breast Reconstruction with an Acellular Dermal Matrix (ADM) Following Nipple-Areola Complex Reconstruction

Abstract

A 48-year-old patient underwent skin-sparing mastectomy for multicentric intraductal carcinoma in situ of the left breast. Immediate reconstruction was done with an implant placed under the pectoralis major muscle, which was covered with a dermoglandular flap dissected from the inferior pedicle. Concomitantly, a contralateral mastopexy with a superior-based pedicle was performed for symmetry (Fig. 40.1a–c). Pathological examination of the mastopexy specimen incidentally found a multicentric intraductal carcinoma in situ, which was not seen in the preoperative mammogram. The pathological result was discussed with the patient, and a nipple-sparing mastectomy with immediate reconstruction with an implant was planned. The breast was of medium size with moderate ptosis (Fig. 40.1a, b).