Inferior dermal sling is one of the techniques for implant/expander based reconstruction in ladies that have larger cup size with ptosis. The incision is a Wise-pattern skin reducing mastectomy with or without nipple preservation. the marking of the wise pattern is more conservative with less skin excision that a Mammoplasty so that the wounds closure is not under-tension after putting the expander/implant. The inferior part of the marked area of the skin is de-epithelialised and used to cover the lower pole of the expander/implant, while the pectorals major is raised to cover the upper part to create the pocket.

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In the next few videos you will see Mr Gerald Gui from the Royal Marsden Hospital doing a skin reducing nipple sparing mastectomy with expander based reconstruction. 

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