Concurrent Skin Reduction in Nipple Sparing Mastectomy and Immediate Tissue Expander Reconstruction for Grade Three Ptosis Breasts

Hubert B Shih,Afaaf Shakir Bs

doi:10.4172/2472-1905.100013

Hubert B Shih, Afaaf Shakir Bs

Open Access

https://doi.org/10.4172/2472-1905.100013

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Abstract

However, not all women are candidates for the operation. From an oncologic perspective, NSM is limited to women with small, early stage peripheral cancers [1, 2]. From a plastic surgery perspective, the NSM is typically offered to women with small breasts and minimal ptosis. The large breasted woman with significant ptosis faces risks with this operation, including NAC and skin necrosis due to poor perfusion to the long mastectomy skin flaps, NAC malposition, and poor contour and profile of the breast due to redundant skin.

Highlights

The nipple-sparing mastectomy (NSM) is a significant advancement in the care of the breast cancer patient, allowing the potential for an excellent cosmetic result while maintaining oncologic benefits [1]
We report a technique used in two patients with grade three ptosis whereby an initial nipple areolar complex (NAC) devascularization procedure is performed, followed four weeks later with NSM and skin reduction using either a Wise or peri-areolar pattern de-epithelialization and infolding technique, and placement of a tissue expander
Two patients with grade three ptosis underwent bilateral NAC devascularization followed by NSM and immediate tissue expander breast reconstruction with skin reduction in either a Wise pattern or peri-areolar pattern

Summary

Introduction

The nipple-sparing mastectomy (NSM) is a significant advancement in the care of the breast cancer patient, allowing the potential for an excellent cosmetic result while maintaining oncologic benefits [1]. Preserving the nipple areolar complex (NAC) is shown to have increased patient satisfaction after breast reconstruction [1]. NSM is limited to women with small, early stage peripheral cancers [1, 2]. From a plastic surgery perspective, the NSM is typically offered to women with small breasts and minimal ptosis. The large breasted woman with significant ptosis faces risks with this operation, including NAC and skin necrosis due to poor perfusion to the long mastectomy skin flaps, NAC malposition, and poor contour and profile of the breast due to redundant skin

Methods

Results

Conclusion