Immediate Implant-/ADM-Based Breast Reconstruction

Michel Sheflan*, Iain Brown, Tanir M. Allweis

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


This chapter will put forward the case for controlled coverage and support of a definitive implant or tissue expander, for improved, long-term outcomes, in immediate implant-based breast reconstruction. Tissue support is provided mostly with an acellular dermal matrix (ADM) or less frequently with de-epithelialised lower pole dermal sling (LPS). We will discuss the surgical considerations for an optimal skin-sparing mastectomy (SSM), nipple-sparing mastectomy (NSM) or skin-reducing mastectomy (SRM) for both risk-reducing mastectomy and therapeutic mastectomy for breast cancer, and the correct selection of the most appropriate lower pole support and implant to acchieve a good result. Specific techniques of pocket dissection will be discussed for both ADM-based and LPS-based pockets, with emphasis on how to define the infra-mammary fold (IMF) and the lateral mammary fold (LMF) and offload the weight of the implabt off the lower pole soft tissue envelope of the breast. The chapter will outline the early and delayed complications and experience with the techniques described as well as suggested strategies (including optimising radiotherapy planning, delayed fat grafting) for successful management.

Original languageAmerican English
Title of host publicationOncoplastic and Reconstructive Breast Surgery, Second Edition
PublisherSpringer International Publishing
Number of pages29
ISBN (Electronic)9783319629278
ISBN (Print)9783319629254
StatePublished - 1 Jan 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© Springer International Publishing AG, part of Springer Nature 2013, 2019


  • Acellular dermal matrix (ADM)
  • Implant reconstruction
  • Infra-mammary fold (IMF)
  • Lateral mammary fold (LMF)
  • Lower pole sling (LPS)
  • Nipple-sparing mastectomy (NSM)
  • Skin-reducing mastectomy (SRM)
  • Skin-sparing mastectomy (SSM)


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