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TECHNIQUE A skin reducing mastectomy is performed via Wise pattern incisions, retaining an extensive inferior dermal sling of de-epithelialised tissue. A sizer is used to ensure the skin envelope meets the inframammary fold before an anatomical implant is placed on the pectoralis major. Complete coverage is achieved with the inferior dermal sling, which is sutured to the pectoralis superiorly. The superior skin can then be draped to the inframammary fold and sutured in the usual manner.

A pure dermal sling for implant reconstruction after mastectomy in the generous breast