METHOD FOR PREPECTORAL RECONSTRUCTION WITH IMPLANT WITH TEXTURED COATING FOR SMALL AND MEDIUM-SIZED MAMMARY GLANDS, “PINCH TEST” MORE THAN 1 CM, II-III DEGREE PTOSIS Russian patent published in 2021 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to oncology. The patient is marked in a standing position, the skin is incised according to the intended marking, a subcutaneous radical mastectomy is performed and a silicone implant with a textured coating is installed subglandular. Moreover, the thickness of the skin and subcutaneous fat should be more than 1.0 cm, a preoperative marking is applied to the skin as shown in Fig. 1. A marking of the breast crease is applied to perform a subcutaneous mastectomy, and the axillary region is marked to perform a lymph node dissection/biopsy of the sentinel lymph node. Then, according to the planned marking, a skin incision is made and the gland tissue is subcutaneously removed, the integumentary tissues are separated, the glandular tissue is separated from the pectoralis major muscle and removed without violating the integrity of the pectoralis major muscle. At the same time, a silicone implant with a textured coating of the appropriate size and shape is installed in the prepared skin-muscular bed on the surface of the pectoralis major muscle, an active drainage is installed, then a lymph node dissection or biopsy of the sentinel lymph node is performed in the axillary region from a separate access, after which the subcutaneous tissue and skin are sutured with an intradermal suture.

EFFECT: method makes it possible to maintain the functionality of the pectoralis major muscle and achieve the most natural appearance of the breast; simplify the surgery technique compared to the sub-sectorial installation of the endoprosthesis; reduce the time and volume of surgery; reduce bed days in the hospital; provide the absence of “Red breast syndrome” (a specific complication characteristic of the polyurethane coating and the acellular-dermal matrix, most often used in pre-sectorial reconstruction); achieve maximum symmetry with the contralateral breast; reduce the risk of capsular contracture; preserve the natural mobility of the breast.

1 cl, 11 dwg, 3 ex