Joseph W. Rucker
MD FACS, American Society of Plastic Surgery
Title: Long Term Outcomes After Breast Reconstruction Utilizing A Template Designed Technique for Inframammary Fold Placement and Breast Mound Positioning
Biography
Biography: Joseph W. Rucker
Abstract
BACKGROUND/OBJECTIVE: A new method offered for a less technically demanding, and more predictable technique for post-mastectomy inframammary fold reconstruction utilizing a lower thoracic advancement flap, the placement of a suture sling template acting as a guide for IMF placement and internal IMF fixation. It has been the authors experience that, a smooth well defined and properly placed inframammary fold (IMF) is the most important factor in producing a natural appearing breast mound and secondarily a more symmetrical reconstructive result. Because of the authors inability to consistently reconstruct this important structure this method was developed.
METHODS: 118 patients over a 27-year history, selected for IMF reconstruction from 2 main categories. Group 1 consisted of 92 patients that underwent IMF reconstruction with a permanent suspension suture technique which was connected to the sternum medially and to the fourth rib laterally. These patients had undergone a delayed prosthetic reconstruction after a tissue expansion phase. Group 2 consisted of the remaining 26 patients that underwent a temporary placement of a suspension suture to act only as a guide for IMF placement which was subsequently removed after fixation of the IMF to the chest wall. The patients in Group 2 fell into the category of either a revision of a post mastectomy reconstruction with displacement of IMF position or the loss of IMF definition immediately following a skin sparring mastectomy.