Document Detail


Nipple-sparing mastectomy: technical aspects and aesthetic outcomes.
MedLine Citation:
PMID:  22531398     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: : Nipple-sparing mastectomy (NSM) is increasingly used to improve the results of immediate breast reconstruction. Technical aspects and aesthetic outcomes of this procedure are examined.
METHODS: : A study of a prospective institutional database of all cases of NSM between 2009 and 2010 was performed. Aesthetic outcomes (symmetry, inframammary fold, volume, contour, and nipple) are compared with patients undergoing skin-sparing mastectomy and immediate breast reconstruction by grading postoperative photographs. Technical refinements in incision types and nipple positioning are described.
RESULTS: : Twenty-six patients underwent 40 NSMs during the study period. Partial nipple necrosis occurred in 15 breasts (37.5%); of them, 14 healed uneventfully with local wound care, and 1 patient required delayed nipple reconstruction. Nipple necrosis by incision type was radial/circumareolar in 6 of 8 (75%) patients; radial, 3 of 9 (33.3%); inframammary fold, 6 of 22 (27.3%); and vertical, 0 of 1 (0%). The nipple aesthetic outcome was significantly better for NSM compared with nipple reconstruction after skin-sparing mastectomy (P = 0.01).
CONCLUSIONS: : The incidence of partial nipple necrosis was high and was related to circumareolar incisions. Most cases of nipple necrosis are superficial and heal uneventfully. Preservation of the nipple improves the aesthetic outcome of immediate breast reconstruction.
Authors:
Hunter R Moyer; Bahair Ghazi; Jarrod R Daniel; Renee Gasgarth; Grant W Carlson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  68     ISSN:  1536-3708     ISO Abbreviation:  Ann Plast Surg     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  446-50     Citation Subset:  IM    
Affiliation:
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
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