Simple anchoring suture to minimise asymmetric nipple-areola complex (NAC) in immediate unilateral breast reconstruction with implant

Lee, Jun Ho; Hur, Su Won; Kim, Yong-Ha; Kim, Tae-Gon; Lee, Soo Jung; Kang, Su Hwan; Choi, Jung Eun

doi:10.1016/j.bjps.2014.09.033

Cited by 1 publication

(1 citation statement)

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“…Such procedures include: the aseptic preoperative drape technique, preoperative coverage of the NAC and umbilicus with surgical film, and handling of breast and NAC with minimal tension. Moreover, an omega-shape periareolar skin incision and anchoring suture are effective ways to decrease suture site tension and prevent skin necrosis (21). Additionally, irrigation using a solution of antibiotics in combination with postoperative hyperbaric therapy is useful for avoiding intraoperative infection and skin flap ischemia.…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis between complication and nipple areola complex preservation in direct-to-implant breast reconstruction

Lee¹,

Choi²,

Sakong³

2021

Gland Surg

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Background: Since the introduction of skin-sparing mastectomy (SSM), more breast surgeons have been preserving the areola and often nipple areolar complex (NAC) entirely. For better outcomes, more studies are necessary to analyze whether preserving the areola or NAC is unfavorable in breast reconstruction. The aim of this study was to assess the potential risk of areola or NAC preservation in direct-to-implant (DTI) breast reconstruction after SSM. Methods: We retrospectively reviewed the medical records of patients who underwent immediate breast reconstruction from May 2011 to July 2017. Immediate breast reconstruction was performed with DTI procedure in all cases. In total, 213 breasts met the inclusion criteria and were divided into 3 groups: nipplesparing mastectomy (NSM), aerola-sparing mastectomy (ASM) which only nipple is excised, and skin-sparing mastectomy (SSM) which whole NAC was excised. Complications including infection, capsular contracture, skin necrosis and explantation were measured. Results: The mean patient age was 45.3 years, with a range of 27-62 years; the mean follow-up was 3.08 years. NSM, ASM and SSM groups consisted of 121, 30 and 62 breasts, respectively. The Infection rates were statistically lower in SSM group (4.8%) compared with NSM group (15.7%) (P=0.033) but not statistically different from ASM group (13.3%) (P=0.210). SSM group showed significantly lower rate of overall complication compared with both NSM and ASM groups (P=0.005, 0.025 respectively).Conclusions: Our research suggests that preservation of the NAC increases the rate of infection and skin necrosis in DTI breast reconstruction.

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Section: Discussionmentioning

confidence: 99%