[Cutaneous suspension: immediate breast reconstruction with abdominal cutaneous advancement using a non-resorptive mesh. Preliminary results and report of 28 cases].

The immediate breast reconstruction with a definitive prosthesis (IBRDP) is the most useful technique in our experience. We proposed a technique to allow the use of IBRDP also in cases of mastectomy with large skin excision and also to permit a better definition of the inframammary fold. The prosthesis pocket is prepared as usually with the pectoralis major and serratus anterior muscles and then, a skin flap is undermined about 6-8 cm below the inframammary fold to prepare an upper abdominal skin flap. The innovation point is the use of a triangular non absorbable mersilene mesh to pull up and maintain the flap. The mesh is initially sutured at the future inframammary fold projection 4 to 6 cm lower than the previous inframammary fold and sutured under tension to the third and fourth costal cartilages. The prosthesis is located in front of the mesh and behind the muscles. Twenty nine patients had a mastectomy with IBRDP with the "Cskin suspension" technique at European Institute if Oncology (IEO) from june 1995 to september 1996. Only one case (3.4%) had a prosthesis loss 3 months after the surgery, probably by a prosthetic material rejection. This technique permits an IBRDF for the patients with a good abdominal skin laxity and also avoids the use of a more complicate or a more expensive technique (myocutaneous flaps or skin expanders). The small post-operative complications rate must be confirmed by a larger follow-up to evaluate the capsular contracture rates and the final cosmetic results.