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Abstract
Abstract Background Nipple Sparing Mastectomy (NSM) has gained popularity due to its improved aesthetics and oncological outcomes. This study focuses on staged mastopexy as a technique for optimizing aesthetics in patients with a history of NSM and implant-based reconstruction. Objectives Our goal was to evaluate staged mastopexy as a technique to address complications such as implant and nipple-areolar complex malposition, rippling, and ptotic skin envelope, with a focus on patient selection, surgical technique, and patient-reported outcomes. Methods We performed a retrospective analysis on a series of five patients who underwent NSM and immediate implant-based reconstruction with staged mastopexy by a single surgeon between 2020 and 2023. Descriptive analyses and t-tests were used. Significance was defined as p ≤ 0.05. Results The cohort consisted of five patients (10 breasts) with a median age of 43 ± 6.5 years and average body mass index was 22.9 ± 2.2 kg/m2. The mean interval from mastectomy to mastopexy was 431.5 ± 232.1 days. Notably, no cases of partial or total nipple necrosis were observed. BREAST-Q surveys revealed significantly higher satisfaction scores for breasts (74. ± 19.9, p=0.01) compared to normative values, with an 80% response rate. Conclusions Staged mastopexy demonstrates a safe and reproducible technique for correcting nipple and implant malposition following nipple sparing mastectomy and implant-based reconstruction.
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