“Immediate breast reconstruction with a Wise pattern mastectomy and NAC-sparing McKissock vertical bipedicle dermal flap”

Preservation of the nipple-areola complex (NAC) in immediate reconstruction of ptotic and large breasts is surgically challenging. This article presents a modification of the inferior dermal flap ("dermal sling") to a vertical bipedicle flap with NAC preservation. The flap is well described in breast reductions, but has never been described in a mastectomy setting. The study reviews data for a case series of 17 breasts in 11 women who were reconstructed with the new technique. The complication rate was 12 percent and the vertical bipedicle NAC-sparing flap has to be considered a feasible option in women with ptotic and/or large breasts.