Can Nipple‐sparing Mastectomy and Immediate Breast Reconstruction with Modified Extended Latissimus Dorsi Muscular Flap Improve the Cosmetic and Functional Outcome among Patients with Breast Carcinoma?

Abstract

Nipple-sparing mastectomy with immediate breast reconstruction using modified extended latissimus dorsi muscular flap allows single-stage, totally autologous reconstruction with a satisfactory aesthetic result, low morbidity, and good quality of life.

Patient Satisfaction following Nipple-Sparing Mastectomy and Immediate Breast Reconstruction: An 8-Year Outcome Study [Outcomes Article]

“…This finding is supported by previous studies demonstrating that independent observers tend to be more critical of outcomes compared with postmastectomy patients. 30,31 We believe this discrepancy is secondary to the altered expectations of postmastectomy women who are more concerned with breast preservation and disease-free survival than cosmesis.…”

Skin and Nipple-Areola Complex Sparing Mastectomy in Breast Cancer Patients

“…A similar but modified technique of this incision is a claw-like incision popularized by Denewer and Farouk. 36 The inframammary approach involves a more difficult path and less access to the axilla. In the case of ptotic breasts, we prefer a supraareolar incision with lateral extension and excision of the supraareolar skin because of nipple elevation in the proper position.…”

Nipple-Sparing Mastectomy

“…15 The aesthetic outcomes after NSM and immediate breast reconstruction (IBR) have been reported to be excellent to good in 75% to 90% of patients. 9,[17][18][19][20] Most studies were either subjective in nature or relied on patient questionnaires with inherent bias. Yueh et al performed 17 NSM in 10 patients, 9 of whom completed aesthetic satisfaction questionnaire.…”

“…The reported incidence of nipple necrosis following NSM ranges from 0% to 48% in the literature, with most series reporting a 10% to 15% incidence. 8,9,12,13,15,17,[25][26][27][28][29][30][31] Predisposing factors include incision type, thickness of NAC (nipple coring), breast size, reconstruction type, and tobacco smoking. Garwood et al showed that incisions around Ͼ30% of the areolar circumference were an independent risk factor for necrosis.…”