Breast SurgeryThe “Type V” Skin-Sparing Mastectomy for Upper QuadrantSkin ResectionsSantanelli, Fabio MD, PhD*; Paolini, Guido MD, PhD*; Campanale, Antonella MD†‡; Longo, Benedetto MD*; Amanti, Claudio MD, PhD§Author Information From the *Plastic Surgery Unit, Sant'Andrea Hospital, II School of Medicine, “Sapienza” University of Rome, Italy; †Sant'Andrea Hospital, II School of Medicine, “Sapienza” University of Rome, Italy; ‡Plastic Surgery Unit, “Ospedali Riuniti” Hospital, School of Medicine, University of Foggia, Italy; §Breast Surgery Unit, Sant'Andrea Hospital, II School of Medicine, “Sapienza” University of Rome, Italy. Received June 16, 2009, and accepted for publication, after revision, October 14, 2009. Reprints: Fabio Santanelli, MD, PhD, Via di Grottarossa 1035–1039, 00189 Rome, Italy. E-mail: [email protected]. Annals of Plastic Surgery: August 2010 - Volume 65 - Issue 2 - p 135-139 doi: 10.1097/SAP.0b013e3181c60f41 Buy Metrics Abstract Skin-sparing mastectomies (SSMs) are classified according to the type of incision and breast size. In large breasts, if cancer is superficially located in the upper quadrants, SSM type IV is not indicated, because tumor resection interferes with skin flap pattern. For these patients, a modified Wise-pattern SSM has been developed to achieve immediate breast reconstruction. Twenty-four patients, 14 with tumor in the superior-lateral, 7 in the superior-medial, and 3 in the inferior-lateral quadrant, were operated on with modified SSM incisions. To replace the skin area removed with mastectomy from the upper quadrants, a similar size area from the lower pole was used. No local or distant recurrences occurred, with a mean follow-up of 27 months. Natural breast shape was achieved in all cases. Our procedure allows for a skin-sparing mastectomy (SSM type V) with immediate reconstruction, achieving a natural breast shape also in this group of patients previously excluded. © 2010 Lippincott Williams & Wilkins, Inc.