a

Bilateral skin-sparing mastectomy

this is a video of a bilateral skin

sparing mastectomy

an incision is made on both sides of the

areola

it is important to preserve as much skin

as possible

using diathermy the mammary gland is

dissected from the surrounding tissue

down to the pectoralis major muscle

the skin is held taut during the

dissection to avoid perforation

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the pectoralis major muscle is exposed

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the specimen is removed it is labeled

medially with a suture and sent to the

pathologist

some remaining memory tissue was removed

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both breasts are now removed and most of

the skin is preserved

reconstruction starts immediately in

this case expander prosthesis will be

placed under the pectoralis major muscle

an incision is made in the middle of the

muscle

a pocket is prepared under the muscle

and serratus fascia

thorough Hamas ptosis is carried out

during the surgery

a drain is placed in the mastectomy

cavity

the skin is washed with alcohol before

the prosthesis is put in place

this is the expander prosthesis

currently not injected with saline

solution

any air in the prosthesis must be

removed

the prosthesis is placed in the pocket

under the muscle

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the muscle is sutured over the

prosthesis

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the skin is closed with two layer

suturing

the center of the prosthesis contains a

small piece of metal to magnetically

locate the fluid injection point

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a special vent and spring-loaded pump is

mounted on the syringe saline solution

is sucked into the syringe when

retracted when pressed down the vent is

closed and the solution is injected into

the prosthesis the drain is activated

and the prosthesis is filled with about

250 milliliters of saline as the

prosthesis expands fluid is drained from

the wound

here we see both breasts with half

filled prostheses

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