New Technique of Immediate Nipple Reconstruction During Immediate Autologous DIEP or MS-TRAM Breast Reconstruction

Hýža, Petr; Streit, Libor; Veselý, Jiří; Stafova, Dagmar; Šín, Petr

doi:10.1097/sap.0000000000000006

Cited by 10 publications

(8 citation statements)

References 27 publications

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“…The healing period of the nipple does not exceed that of the breast and back. Some institutions reserve the combination of autologous reconstruction and immediate NAC reconstruction for patients who are not being considered for radiotherapy [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…This is the senior author’s preferred technique. Alternative techniques for simultaneous NAC reconstruction include a modified star flap or the Hartrampf wrap-around flap described by Hyza et al [ 18 ]. Williams et al [ 10 ] introduced a further variation, involving TRAM flap breast reconstruction with simultaneous NAC reconstruction using a fishtail or trilobed flap in 10 patients.…”

Section: Discussionmentioning

confidence: 99%

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Skin-sparing mastectomy with immediate nipple reconstruction during autologous latissimus dorsi breast reconstruction: A review of patient satisfaction

et al. 2018

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BackgroundNipple-areolar complex (NAC) reconstruction following curative mastectomy is traditionally performed as a second-stage procedure several months after initial breast reconstruction. The recent literature has documented the increasing popularity of immediate nipple reconstruction carried out simultaneously during autologous reconstruction. The aim of this study was to evaluate the surgical outcomes and patient satisfaction with immediate breast and nipple reconstruction performed in a single stage after skin-sparing mastectomy.MethodsAll patients who underwent a skin-sparing mastectomy with immediate latissimus dorsi flap breast and NAC reconstruction as a single-stage procedure from 2007 to 2015 were included. Patient demographics, oncologic details, and surgical outcomes were recorded. The BREAST-Q questionnaire was administered to patients to assess the impact and effectiveness of this reconstructive strategy.ResultsDuring the study period, 34 breast and NAC reconstructions in 29 patients were performed at Cork University Hospital. The majority of our patient cohort were non-smokers (93.1%) and did not receive adjuvant radiotherapy. Postoperative complications were infrequent, with no cases of partial necrosis or complete loss of the nipple. The response rate to the BREAST-Q was 62% (n=18). Patients reported high levels of satisfaction with the reconstructed breast (62±4), nipple reconstruction (61±4.8), overall outcome (74.3±5), and psychosocialwell-being (77.7±3.2).ConclusionsSkin-sparing mastectomy with immediate nipple reconstruction during autologous latissimus dorsi reconstruction was demonstrated to be a safe and aesthetically reliable procedure in our cohort, yielding high levels of psychological and physical well-being. A single-stage procedure promotes psychosocial well-being involving issues that are intrinsically linked with breast cancer surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Skin-sparing mastectomy with immediate nipple reconstruction during autologous latissimus dorsi breast reconstruction: A review of patient satisfaction

et al. 2018

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“…An alternative approach to delayed surgery for breast cancer patients is immediate nipple reconstruction. Several techniques have been presented for performing such types of reconstructions, both in autologous and implant-based breast reconstructions [5,6,7,8,9,10]. However, the tailoring strategy for individual patients and the expectations for rapid aesthetic successes still power breast surgery evolution.…”

Section: Introductionmentioning

confidence: 99%

A novel technique for immediate nipple reconstruction with a rectangular flap in implant-based breast reconstruction

2021

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IntroductionA nipple reconstruction complements breast mound restoring in postmastectomy breast cancer patients. It positively affects patients' welfare, both in psycho-social and sexual aspects. An immediate nipple reconstruction is an alternative approach to delayed surgery. We describe an original technique for an immediate nipple reconstruction by the use of a modified rectangular flap.Material and methodsOne hundred seventeen nipple reconstructions in 112 breast cancer patients were performed. This technique was used during skin-sparing mastectomy, including 104 implants (88.9%) and 13 tissue-expander (11.1%) breast reconstructions. Synthetic meshes covered with titanium supported lower breast poles in 72 implantations (61.5%); in remaining cases, (38.5%) muscles covered the entire implant. Preoperative chemotherapy was applied in 18.75% of the patients; adjuvant chemo- and hormonal therapy obtained 29.5% and 74.1% of the patients, respectively. Twenty-four patients (21.4%) were irradiated postoperatively.ResultsIn 5 out of 117 surgeries (4.3%), necrosis of the rectangular flap was observed. Twelve months since surgery, two-loss of projection of reconstructed nipple was reported (1.7%). In the twelfth month of observation, of the subgroup of 102 patients with permanent nipple presentation, 93.1% gave a positive opinion regarding the procedure.ConclusionsThe given immediate nipple reconstruction technique performed during a skin-sparing mastectomy and implant/expander-based breast reconstruction was an effective and safe adjunct curative breast surgery.

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“…Aside from a report on immediate nipple reconstruction in autologous latissimus dorsi flap 8 or deep inferior epigastric perforator flap 9 reconstruction, historically NAC reconstruction is a secondary procedure performed months after initial breast reconstruction. 10 The patient has a period without NAC and a delay in the completion of reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Immediate Nipple-Areolar Complex Reconstruction for Patients Undergoing Implant-Based Reconstruction or Therapeutic Mammoplasty

Highton

Murphy

2017

Plastic and Reconstructive Surgery - Global Open

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Background:We report a technique of immediate nipple-areolar complex (NAC) reconstruction for patients undergoing skin-sparing mastectomy and implant-based breast reconstruction or therapeutic mammoplasty with central excision.Methods:Immediate nipple reconstruction is performed using a modified C-V flap planned along the edge of the incision. The areola is reconstructed using a full-thickness skin graft taken from skin usually discarded during the procedure. Immediate NAC reconstruction using this technique was performed on 32 breasts in 21 patients. This included 19 risk-reducing mastectomies, 9 therapeutic mastectomies, and 2 major revisions to existing implant reconstruction. Reconstruction was direct to implant in 29 breasts and by expander in 1 breast. The device was placed in a pre- or post-pectoral plane utilizing dermal sling and/or acellular dermal matrix as determined on a case-by-case basis. Immediate NAC reconstruction was also performed on 2 patients undergoing therapeutic mammoplasty with central excision.Results:Mean follow-up is 12 months (5–27 months), and cosmetic results have been good. There have been no significant complications, and no revisional surgery has been required.Conclusion:The application of simple techniques for NAC reconstruction in the primary procedure allows reconstruction of the whole breast in a single stage. There is an immediate focal point to the reconstruction to improve cosmesis, patient satisfaction, and psychosocial function without delay.

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New Technique of Immediate Nipple Reconstruction During Immediate Autologous DIEP or MS-TRAM Breast Reconstruction

Cited by 10 publications

References 27 publications

Skin-sparing mastectomy with immediate nipple reconstruction during autologous latissimus dorsi breast reconstruction: A review of patient satisfaction

Skin-sparing mastectomy with immediate nipple reconstruction during autologous latissimus dorsi breast reconstruction: A review of patient satisfaction

A novel technique for immediate nipple reconstruction with a rectangular flap in implant-based breast reconstruction

Immediate Nipple-Areolar Complex Reconstruction for Patients Undergoing Implant-Based Reconstruction or Therapeutic Mammoplasty

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