Research Article
Outcomes of Dermal Sling Based Breast Reconstruction
Tarannum FasihBackground: Dermal sling is a de-epithelialized skin flap created for breast reconstruction. It acts as a cover for the breast implant placed in the sub muscular pocket. The advantage of this technique is the use of redundant breast skin to act as support for the implant whilst also reducing size of the breast. The aim of this study is to review outcomes following this type of reconstruction. Methods: All patients undergoing this form of breast reconstruction from 2011- April 2015 were included. The indication of surgery (cancer and prophylactic group), implant sizes, neo-adjuvant and adjuvant treatment given, follow up and significant local complications were recorded. Results: 23 patients underwent 28 procedures. 15 ladies had breast cancer and13 had prophylactic surgery. Average size of implant used was 532g (295-765g). 5 received radiation to the reconstructed breast 1 had previous wide local excision & radiation. 9 patients had adjuvant and 1 had neo-adjuvant chemotherapy. No loss of implant was seen after radiation treatment. Follow up was 49.3 months (7-56).There was necrosis of T junction in 1 patient who had previous radiotherapy treatment after WLE. 3(10.7%) cases of infection were seen, 1 of the patient lost the implant due to severe infection. There were 2 local recurrences and 1 reconstruction was taken down. 2 extrusions of implant took place 1 of which was replaced and 1 was lost. Total implant loses were seen in 3 cases (10.7%). Conclusion: Dermal sling reconstruction is a safe option despite local and systemic adjuvant treatment and has a dual benefit of creating a smaller breast and avoids using a biological or synthetic mesh: the long-term results of which are not known