Simultaneous reconstruction using endoprosthesis and lower deepithelialized flap in prophylactic mastectomy

Objective. To analyze long-term outcomes and quality of life after simultaneous breast reconstruction. Material and methods. The study included 31 patients who underwent prophylactic subcutaneous mastectomy and simultaneous reconstruction with implant and inferior de-epithelialized dermal flap. Results. Complications occurred in 19.35% of cases. Implant volume and de-epidermized skin were not related to the incidence of complications. Postoperative satisfaction with mammary gland and psychosocial well-being were significantly lower (p<0.001), but no significant difference in sexual and physical well-being was found (p=0.118 and 0.084, respectively). Conclusion. The authors presented a method of breast reconstruction after subcutaneous prophylactic mastectomy. De-epithelialized dermal flap as additional reinforcement of the lower pole of the reconstructed mammary gland is advisable to achieve the best aesthetic results in patients with severe ptosis (grade III-IV) and minimal pinch test. © 2025 Elsevier B.V., All rights reserved.