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a b

c
Figure 5: Picture showing right de‑epithelialized inferior dermoglandular Figure 6: (a‑c) Preoperative pictures of the patient before explantation
flap sutured to pectoralis major muscle

a b
a b

c
c
Figure 8: (a‑c) Postoperative pictures showing results after 6 weeks
Figure 7: (a‑c) Postoperative pictures showing results after 2 weeks following explantation and inferior dermoglandular de‑epithelialized flap
following explantation and inferior dermoglandular de‑epithelialized flap
The de‑epithelialized flap maximizes implant coverage
commonly performed procedure by plastic and aesthetic adding an extra layer of autologous tissue to minimize
surgeons today. Implant related mammoplasties for both its extrusion. [3‑4] The inferior dermoglandular flap has
primary and revision mammoplasties is considered a also been described when simultaneous augmentation
safe procedure with a high satisfaction rate and is due mammoplasty is performed with mastopexy. Volume
[5]
to the information available on the product, premarket enhancement using autologous fat transfer is safe
surveys, enhanced implant safety and regular quality and commonly performed today for cosmetic as well
checks in place. It is not surprising that in 2012 as reconstructive procedures since the publication of
[1]
alone 330,631 implant related mammoplasties were the article by Coleman. However, in cases following
[6]
performed in USA. On the other hand, breast implant explantation of prosthesis, the patients are left with
[2]
explantation without implant replacement following quite large empty space with a thin breast skin envelope
primary augmentation mammoplasty is very uncommon, that can make the autologous fat transfer not an easy
the prevalence of the procedure or its incidence is option. Volume restoration and aesthetic appearance
lacking in the literature. In author’s own experience, following explantation can be even more challenging
only three patients have requested explantation without if there is an associated ptosis. However, if a patient
breast implant replacement after performing over 4,000 presents with a markedly ptotic breast, the use of the
implant related cosmetic mammoplasties. The rarity of excess skin can be materialized. In these cases, wise
the procedure makes it difficult to compile the effects pattern mastopexy can be performed with the use of
on the patient or record the management of the loss an inferior dermoglandular flap. This de‑epithelialize
of volume or resultant deformity. Explantation of breast flap conserves breast volume and helps to remodel the
prosthesis results in empty stretched and thinner skin breast in this group of selected cases. The procedure
envelope that is often accompanied with breast ptosis. can also be staged where explantation can be performed
The inferior de‑epithelialized dermoglandular flap has initially followed by mastopexy at least 3 months later to
been described for breast reconstruction with an aim adjust any recoil of the breast. Vertical scar mastopexy
to cover the prosthesis in the lower part of the breast. can be a possible option to conserve breast tissue, but

Plast Aesthet Res || Vol 2 || Issue 2 || Mar 13, 2015 83