Premise: Modern approaches to skin-sparing mastectomy produce impressive esthetic results with a high degree of symmetry. However, functional properties of the reconstructed breast (haptic properties, consensual mobility) often leave much to be desired. The article presents an original technique of skin-sparing surgeries for breast cancer with immediate reconstruction using a thoracodorsal flap pre-modified by lipofilling.

Methods: The study included 18 patients with breast cancer who underwent skin-sparing mastectomy for breast cancer with immediate breast reconstruction using a thoracodorsal flap pre-modified by lipofilling. The article determines indications for this surgical intervention and describes lipofilling technique within the projection of the future thoracodorsal flap, breast tissue removal, flap dissection and formation of a symmetrical breast. 

Results: The results were assessed using the BCCT.core 3.0 software, and the numbers of excellent and good results were similar. In 5 cases (27.8%), breasts were absolutely symmetrical not only visually, but haptically as well. A small percentage of complications allowed considering the suggested surgical intervention to be an effective method for breast reconstruction.

Conclusions: Breast reconstruction with a thoracodorsal flap which was previously subjected to lipografting, as well as disuse of combination of a tissue flap with an implant, provide consensual breast mobility and better breast symmetry both visually and haptically.

Keywords:
Breast cancer; skin-sparing mastectomy; reconstructive mammoplasty; thoracodorsal flap; lipografting; intramuscular lipofilling; tissue engineering.