Use of the axillary suspensory ligament as an adipo-fascial flap for total subpectoral implant coverage in breast reconstruction: a retrospective review

Kyprianou, C; Rysin, R; Harats, M; Gali Tzarfati, G; Kornhaber, R; Cleary, M; Haik, J

Use of the axillary suspensory ligament as an adipo-fascial flap for total subpectoral implant coverage in breast reconstruction: a retrospective review

Kyprianou, C Rysin, R Harats, M Gali Tzarfati, G Kornhaber, R Cleary, M

Haik, J

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Publisher:: Springer Nature
Publication Type:: Journal Article
Citation:: European Journal of Plastic Surgery, 2025, 48, (1), pp. 82
Issue Date:: 2025-12-01

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Field	Value	Language
dc.contributor.author	Kyprianou, C
dc.contributor.author	Rysin, R
dc.contributor.author	Harats, M
dc.contributor.author	Gali Tzarfati, G
dc.contributor.author	Kornhaber, R
dc.contributor.author	Cleary, M https://orcid.org/0000-0002-1453-4850
dc.contributor.author	Haik, J
dc.date.accessioned	2026-08-06T02:47:49Z
dc.date.available	2026-08-06T02:47:49Z
dc.date.issued	2025-12-01
dc.identifier.citation	European Journal of Plastic Surgery, 2025, 48, (1), pp. 82
dc.identifier.issn	0930-343X
dc.identifier.issn	1435-0130
dc.identifier.uri	http://hdl.handle.net/10453/195949
dc.description.abstract	Background: Subpectoral breast reconstruction following mastectomy requires adequate soft tissue coverage to prevent prosthetic complications such as extrusion, capsular contracture, and poor aesthetic outcomes. The suspensory ligament of the axilla (SLA), a fascial structure often overlooked, may offer a novel autologous solution for complete implant coverage without the morbidity or cost associated with acellular dermal matrices or synthetic mesh. Methods: This study assessed postoperative outcomes and complication rates in patients undergoing alloplastic breast reconstruction utilizing the SLA as an adipo-fascial flap for total subpectoral coverage. Twenty patients (24 breasts) underwent immediate reconstruction with the SLA technique between January 2018 and January 2024. Results: The cohort had an average age of 49 years and a mean follow-up duration of 12 months. A total complication rate of 16.6% was observed, including 8.33% minor complications and 8.33% major complications. No cases of skin flap necrosis, implant extrusion, hematoma, or donor site morbidity were reported. Patient satisfaction based on informal self-reporting during follow-up was generally high, with 75% reporting their aesthetic outcome as very good. Conclusion: Early findings suggest the SLA-based subpectoral reconstruction technique may offer a safe, cost-effective alternative for achieving total prosthetic coverage. It eliminates the need for foreign materials, preserves muscle function, and demonstrates a low complication rate. While early outcomes are promising, prospective studies with larger cohorts are needed to further validate its long-term efficacy and safety. Level of evidence: Level IV, therapeutic study.
dc.language	en
dc.publisher	Springer Nature
dc.relation.ispartof	European Journal of Plastic Surgery
dc.relation.isbasedon	10.1007/s00238-025-02333-2
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.classification	Surgery
dc.subject.classification	3202 Clinical sciences
dc.title	Use of the axillary suspensory ligament as an adipo-fascial flap for total subpectoral implant coverage in breast reconstruction: a retrospective review
dc.type	Journal Article
utslib.citation.volume	48
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/School of Nursing and Midwifery
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2026-08-06T02:47:48Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	48
utslib.citation.issue	1

Abstract:

Background: Subpectoral breast reconstruction following mastectomy requires adequate soft tissue coverage to prevent prosthetic complications such as extrusion, capsular contracture, and poor aesthetic outcomes. The suspensory ligament of the axilla (SLA), a fascial structure often overlooked, may offer a novel autologous solution for complete implant coverage without the morbidity or cost associated with acellular dermal matrices or synthetic mesh. Methods: This study assessed postoperative outcomes and complication rates in patients undergoing alloplastic breast reconstruction utilizing the SLA as an adipo-fascial flap for total subpectoral coverage. Twenty patients (24 breasts) underwent immediate reconstruction with the SLA technique between January 2018 and January 2024. Results: The cohort had an average age of 49 years and a mean follow-up duration of 12 months. A total complication rate of 16.6% was observed, including 8.33% minor complications and 8.33% major complications. No cases of skin flap necrosis, implant extrusion, hematoma, or donor site morbidity were reported. Patient satisfaction based on informal self-reporting during follow-up was generally high, with 75% reporting their aesthetic outcome as very good. Conclusion: Early findings suggest the SLA-based subpectoral reconstruction technique may offer a safe, cost-effective alternative for achieving total prosthetic coverage. It eliminates the need for foreign materials, preserves muscle function, and demonstrates a low complication rate. While early outcomes are promising, prospective studies with larger cohorts are needed to further validate its long-term efficacy and safety. Level of evidence: Level IV, therapeutic study.

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http://hdl.handle.net/10453/195949