Surgical Delay of the Nipple–Areolar Complex in High-risk Nipple-sparing Mastectomy Reconstruction
نویسندگان
چکیده
As nipple-sparing mastectomy gains increasing popularity, minimizing the risk of nipple necrosis continues to be of critical importance to patients and surgeons. Patients with large or ptotic breasts, scars from previous cosmetic and/or oncologic breast surgery, or previous irradiation have often been denied nipple-sparing mastectomy (NSM) because of increased risk of nipple necrosis. A variety of interventions have been suggested to minimize the ischemic insult to the nipple-areolar complex (NAC). This article presents our experience in 26 high-risk patients with surgical delay of the NAC.
منابع مشابه
Abstract P5. Delay Techniques for Nipple-Sparing Mastectomy: A Systematic Review
PURPOSE: Complications of nipple-sparing mastectomy (NSM) include necrosis of the nipple-areolar complex (NAC) or mastectomy skin flaps. NAC and mastectomy flap delay procedures are novel techniques designed to avoid these complications, and may be combined with retroareolar biopsy when performed prior to NSM. We performed a systematic review of the literature to evaluate techniques for NAC and...
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Significant ptosis is a relative contraindication for nipple-sparing mastectomy and reconstruction. Repositioning of the nipple on the reconstructed breast is best accomplished using a pedicled approach that is risky in the immediate setting. We utilized a surgical delay before reconstruction that allowed for repositioning of the nipple-areola complex on an inferior pedicle. This also allows fo...
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BACKGROUND Patients with moderate to severe ptosis are often considered poor candidates for nipple-sparing mastectomy. This results from the perceived risk of nipple necrosis and/or the inability of the reconstructive surgeon to reliably and effectively reposition the nipple-areola complex on the breast mound after mastectomy. METHODS A retrospective review identified patients with grade II/I...
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SUMMARY As nipple-sparing mastectomy with implant-based reconstruction has increased, attention must be paid to the viability of the nipple-areolar complex. This article describes the use of preoperative Doppler ultrasound to identify the internal mammary artery perforators. Preserving the internal mammary artery improves vascular supply to the nipple-areolar complex.
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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-thickne...
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