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Superior Crescent Mastopexy for Grade II Ptosis in Nipple Sparing Mastectomy
Joshua MacDavid, Alyssa Simpson, Bradon Wilhelmi
University of Louisville
2022-01-21
Presenter: Joshua MacDavid
Affidavit:
Agree, work is original work of the resident
Director Name: Bradon Wilhelmi
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
INTRODUCTION
An improved understanding of the pathophysiology of breast cancer coupled with improved treatments has allowed more women to be candidates for nipple sparing mastectomy. However, women with Grade II ptosis and above have not traditionally been candidates given inferior aesthetic outcomes and nipple malposition. Herein we describe the technique of a superior crescent mastopexy at the time of tissue expander exchange to implants in order to provide a modest life of the nipple areola complex to improve aesthetic outcomes.
TECHNIQUE
Three patients with Grade II ptosis were included in the study, from July to October of 2021. A crescent is designed superior to the areola, encompassing no more than 180 of the circumference of the NAC during the second stage of tissue expander exchange to implants. The crescent is deepithelialized and the NAC is relocated to its now more superior location.
RESULTS
All three patients were successfully able to undergo crescent mastopexy after nipple sparing mastectomy. We had no major or minor wound complications and appropriate nipple position was able to be achieved.
CONCLUSION
The performance of a superior crescent mastopexy is a safe, simple, and time efficient technique with minimal additional scarring that can improve nipple position allowing for women with ptosis to become candidates for nipple sparing mastectomy.
