Delay techniques for nipple-sparing mastectomy: A systematic review

Karian, Laurel; Therattil, Paul J.; Wey, Philip D.; Nini, Kevin T.

doi:10.1016/j.bjps.2016.11.012

Cited by 32 publications

(19 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In 2006, Sacchini et al reported that they counseled patients with large, ptotic breasts against NSM-citing risks of nipple necrosis and asymmetry (37). Since then, multiple techniques have been cited in the literature for optimizing outcomes of NSM in this breast type: pre-mastectomy delay procedures, pre-or post-mastectomy mastopexies, free NAC graft, and post-mastectomy hyperbaric oxygen therapy (38)(39)(40)(41)(42)(43).…”

Section: Nsm In the Large Ptotic Breastmentioning

confidence: 99%

Autologous reconstruction following nipple sparing mastectomy: a comprehensive review of the current literature

Shay

Jacobs

2018

Gland Surg.

View full text Add to dashboard Cite

As surgical methods continue to evolve and patients become more educated consumers of their medical care, both oncologic breast surgeons and reconstructive plastic surgeons should understand the current options for surgical management of breast cancer. This review evaluates the current autologous breast reconstruction options following nipple sparing mastectomy (NSM). A comprehensive review of the current literature discussing autologous reconstruction after NSM was performed. Fat grafting alone has been used to reconstruct small to medium sized-breasts over multiple injection sessions. Goldilocks mastectomy-like reconstructions can be used for larger, more ptotic breasts. Pedicled latissimus dorsi (LD) flaps can be used, but usually need to be modified to ensure sufficient breast volume. While the lower abdominal tissue remains the most common donor site in free tissue transfer, other donor sites can be used if there is insufficient volume or inadequate perforators. Periareolar incisions are associated with the highest rates of overall complications and nipple areola complex necrosis. It has not been determined whether implant-based or autologous reconstructions have lower complication rates. Both prior radiation and large, ptotic breasts present unique challenges during reconstruction. Overall, there is a high rate of patient satisfaction with breast reconstruction following NSM. Autologous breast reconstruction after NSM is a safe method of breast cancer surgical management with aesthetically excellent results. Multiple techniques have been described along the reconstructive ladder. Special consideration should be given to choices of incision, previously irradiated breasts, and large, ptotic breasts.

show abstract

Section: Nsm In the Large Ptotic Breastmentioning

confidence: 99%

Autologous reconstruction following nipple sparing mastectomy: a comprehensive review of the current literature

Shay

Jacobs

2018

Gland Surg.

View full text Add to dashboard Cite

show abstract

“…Multiple approaches have been described to facilitate nipple-sparing mastectomy (NSM) and reconstruction 4 in the ptotic patient. The most accepted approach was proposed by Spear—an oncoplastic reduction in a first stage followed by subsequent NSM and reconstruction in a second stage.…”

Section: Discussionmentioning

confidence: 99%

A New Approach to Nipple-sparing Mastectomy and Reconstruction in the High Risk Ptotic Patient

Schwartz

2018

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Summary:Nipple-sparing mastectomy (NSM) and reconstruction is challenging in ptotic patients with additional risk factors. Here, these problems are addressed with a staged strategy that extends NSM and reconstruction to patients with grade 3 ptosis and additional risk factors of diabetes, obesity, and macromastia. Three stages are used to perform a mastectomy, reposition the nipple, and reduce the skin envelope using the Wise pattern. This is followed by definitive implant placement in a final fourth stage. All patients successfully completed their reconstructions without a single instance of implant loss. Using a staged approach, NSM and reconstruction in high-risk ptotic patients is feasible. This is facilitated by using multiple surgical delays and insuring a well-healed skin envelope and optimal nipple position before any prosthetic device is placed.

show abstract

“… 5 In patients at increased risk for complications, surgical delay of the nipple can be beneficial. 6 , 7 While many different types of incisions have been used in NSM, the inframammary incision is associated with lower rates of complications, including nipple necrosis. 8 , 9…”

Section: Goals Of the Proceduresmentioning

confidence: 99%

Safe and Efficient Implant-based Breast Reconstruction

Chao

2020

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Summary: Implant-based breast reconstruction is a safe and effective option associated with high patient satisfaction. Techniques have evolved significantly over the past several decades, characterized mostly by a reduction in the number of stages and time required to complete reconstruction, with maximal preservation of native breast elements. Nevertheless, both old and new techniques of implant-based breast reconstruction have a role depending on the specific clinical scenario, and thus plastic surgeons should be well versed in the full spectrum of options. This article reviews the key considerations underlying decision-making in implant-based breast reconstruction and the most effective techniques, with a focus on optimizing safety and efficiency.

show abstract

Delay techniques for nipple-sparing mastectomy: A systematic review

Cited by 32 publications

References 26 publications

Autologous reconstruction following nipple sparing mastectomy: a comprehensive review of the current literature

Autologous reconstruction following nipple sparing mastectomy: a comprehensive review of the current literature

A New Approach to Nipple-sparing Mastectomy and Reconstruction in the High Risk Ptotic Patient

Safe and Efficient Implant-based Breast Reconstruction

Contact Info

Product

Resources

About