<< Back to the abstract archive
Pushing the envelope: skin-only mastopexy in single-stage nipple sparing mastectomy prepectoral direct to implant breast reconstruction
Rachel E. Aliotta MD, Isis Scomacao MD, Grzegorz J. Kwiecien MD, Eliana F. Duraes MD, Alicia Fanning MD, Andrea Moreira MD.
Cleveland Clinic Department of Plastic & Reconstructive Surgery
2019-02-15
Presenter: Rachel E. Aliotta, MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Steven Bernard, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction. Despite advances in skin envelope reduction techniques combined with experienced nipple sparing mastectomy flap procedures, the rate of nipple malposition and secondary revision in these patients remains high. Here we present a novel technique combining skin reduction nipple sparing mastectomy surgery with single stage skin-only mastopexy and direct to implant reconstruction.
Methods. A retrospective review was performed at a single institution from 2015-2018. All patients presented were operated on using this technique consecutively, by a single breast (A.F) and plastic surgeon team (A.M). Outcomes were compared with that of matched reconstructions in currently accepted literature.
Results. Twenty-six patients (40 breasts) underwent this technique; all were single-stage direct to implant (DTI). A wise-pattern was utilized in 35 breasts (87.5%), pre-pectoral placement in 25 breasts (62.5%). Complications included seroma (5 breasts, 12.5%), vertical/T-junction dehiscence/skin necrosis (9 breasts, 22.5%). There was no total nipple-areolar loss. There were no reconstructive failures at average follow up 6 months (0.8-30.2 months).
Discussion. Here we report a novel reconstructive technique in which the skin envelope is reduced, the nipple areolar complex is repositioned, and a direct to implant reconstruction is performed in a single stage at time of mastectomy. Discussion of our pearls and pitfalls accompanies a review of the complication profile with that reported in the literature.
