Abstract: 2 Stage Approach to Autologous Breast Reconstruction Is Cost Effective and Improves Aesthetic Outcomes

INTRODUCTION: The nipple-sparing mastectomy (NSM) improves aesthetic results after breast reconstruction through preservation of the entire skin envelope, obviating the need for reconstruction of the nipple areola complex (NAC). NSM, however, is associated with a higher risk for occult pathology and skin necrosis, which can require resection and compromise the reconstructive outcome. In DIEP flap reconstruction; we utilize a 2-staged approach, which preserves “banked” skin during the initial reconstruction. After skin demarcation or final pathology of the NAC is revealed, a second minor procedure occurs to remove the banked skin or reconstruct the NAC if needed. This study was designed to identify how frequently the banked skin was utilized and the associated operative costs to determine if a staged approach to reconstruction is beneficial.