One-Staged Silicone Implant Breast Reconstruction Following Bilateral Nipple-Sparing Prophylactic Mastectomy in Patients at High-Risk for Breast Cancer

Abstract

There is little consensus regarding the indications, ideal incision, or reconstruction method for prophylactic mastectomy. In addition, the biggest limitation in studies that assess either patient satisfaction or operation results is the lack of group homogeneity. In our center, 21 bilateral prophylactic mastectomies, due to breasts at high risk for cancer, and simultaneous breast reconstruction using submuscular medium-height high-profile silicone implants were performed between 2008 and 2012. The patients were divided into two groups: small-breasted (9 patients) and large/ptotic-breasted (12 patients). A periareolar incision was used in the 9 patients and a vertical mastopexy incision was used in the 12 patients who needed nipple-areola complex repositioning. The rates of general satisfaction and aesthetic outcomes, assessed using the Michigan Breast Satisfaction Questionnaire, were 100 and 90.4%, respectively. Seroma occurred in three patients and venous congestion of the nipple-areola complex developed in four patients, which resolved spontaneously. No nipple-areola necrosis, implant exposition, or capsule contractures were encountered. Only three patients underwent fat injection for contour restoration. We obtained very good aesthetic results with low complication rates using this technique in a homogeneous group of patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .