Single-Stage Breast Reconstruction following Areola-Sparing Mastectomy

Ma, Grace; Richardson, Heather; Pacella, Salvatore J.; Codner, Mark A.

doi:10.1097/prs.0b013e3181a073c6

Cited by 9 publications

(13 citation statements)

References 11 publications

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“…However, a single-stage reconstruction following ASM represents a new and innovative concept [21]. In our series, we found good to excellent results in all cases, and all of the patients were satisfied with the aesthetic results and the fact that they had to undergo surgery only once.…”

Section: Discussionsupporting

confidence: 54%

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One-Stage Nipple and Breast Reconstruction Following Areola-Sparing Mastectomy

et al. 2013

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BackgroundSkin-sparing mastectomy with immediate breast reconstruction is increasingly becoming a proven surgical option for early-stage breast cancer patients. Areola-sparing mastectomy (ASM) has also recently become a popular procedure. The purpose of this article is to investigate the reconstructive and aesthetic issues experienced with one-stage nipple and breast reconstruction using ASM.MethodsAmong the patients who underwent mastectomy between March 2008 and March 2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwent ASM and immediate breast reconstruction with simultaneous nipple reconstruction using the modified C-V flap. The cosmetic outcomes of this series were reviewed by plastic surgeons and patient self-assessment and satisfaction were assessed via telephone interview.ResultsDuring the average 11-month follow-up period, there were no cases of cancer recurrence, the aesthetic outcomes were graded as excellent to very good, and all of the patients were satisfied. Two patients developed a gutter-like depression around the reconstructed nipple, and one patient developed skin erosion in a small area of the areola, which healed with conservative dressing. The other complications, such as necrosis of the skin flap or areola, seroma, hematoma, or fat necrosis did not occur.ConclusionsSince one-stage nipple and breast reconstruction following ASM is an oncologically safe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical option for early breast cancer patients.

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Section: Discussionsupporting

confidence: 54%

“…Since areolar skin necrosis can cause nipple distortion and an aesthetically undesirable areola due to scarring, it is recommended that the areola be sacrificed during the initial surgical procedure if the vascularity of the areolar skin is questionable [21]. The cases in which the areola was sacrificed were excluded from our study.…”

Section: Discussionmentioning

confidence: 99%

One-Stage Nipple and Breast Reconstruction Following Areola-Sparing Mastectomy

et al. 2013

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“…20 Therefore, when the areola is preserved during mastectomy, the oncologic risk is minimized and aesthetic outcome is maximized. 13,21 This article illustrates a subset of patients in whom the areola was preserved as the natural evolution of the skin-sparing mastectomy ( Figure 8A,B). Compared with the routine results achievable with SSM ( Figure 5A,B), we feel that ASM produces a better aesthetic outcome for the reconstructed breast.…”

Section: Areola-sparing Mastectomymentioning

confidence: 99%

“…In our practice, we have collaborated with general surgeons over the past three years to reduce scarring and improve the aesthetic outcomes of their patients. 13,14 Since the advent of ASM in our practice, immediate nipple reconstruction has been performed on the in situ back skin island before elevation of the latissimus muscle, rather than after inset. Refinements have also been made to the selection of an implant or expander for reconstruction, along with operative changes regarding muscle coverage of the chosen implant.…”

mentioning

confidence: 99%

Aesthetic and Technical Refinements in Latissimus Dorsi Implant Breast Reconstruction: A 15-Year Experience

Pacella

Vogel

Locke

et al. 2011

Aesthetic Surgery Journal

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The data demonstrated a successful outcome for latissimus dorsi and implant breast reconstruction for patients with a low or normal body mass index and a small (A to C cup) breast size. The aesthetic outcome of latissimus dorsi breast reconstruction has been improved over the past 15 years by the adoption of SSM and ASM techniques. Immediate nipple reconstruction and the placement of an adjustable saline implant potentially render this procedure a true single-stage reconstruction. Prepectoral implant position provides good aesthetics while preserving the subpectoral space for future management of capsular contracture if required.

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“…For breast reconstruction, the LD myocutaneous flap is a reliable and versatile choice in patients who are relatively thin in the lower abdominal region and have small to moderate breasts . Nowadays, as the psychological benefits of nipple–areola complex reconstruction have been receiving more attention, several authors began to reconstruct the nipple and breast in a single stage to improve the overall patient satisfaction . Delay et al performed the immediate nipple reconstruction using the skin paddle of the LD myocutaneous flap.…”

Section: Discussionmentioning

confidence: 99%

Immediate nipple reconstruction with thoracodorsal artery perforator flap in breast reconstruction by latissimus dorsi myocutaneous flap in patients with Poland's syndrome

Wang

et al. 2015

Microsurgery

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Loss of long-term projection is the major disadvantage of nipple reconstruction using local flaps. We report a technique of immediate perforator flap nipple reconstruction in breast reconstruction by latissimus dorsi (LD) myocutaneous flap in patients with Poland's syndrome. From March 2007 to July 2012, 12 female patients (age range, 15-21 years) underwent breast reconstructions and immediate nipple reconstructions. A thoracodorsal artery perforator (TAP) flap was simultaneously raised on the LD muscle flap and folded by itself to form the nipple. Both the LD flap and TAP flaps survived postoperatively. The nipple projection was measured by a caliper, and the average loss was 29% by the 1-year follow-up. Eleven patients considered the aesthetic appearance of reconstructed breast and nipple to be very good or good. The immediate nipple reconstruction with TAP flap could be safely performed and results in considerable satisfaction in breast reconstruction by LD myocutaneous flap in patients with Poland's syndrome.

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Single-Stage Breast Reconstruction following Areola-Sparing Mastectomy

Cited by 9 publications

References 11 publications

One-Stage Nipple and Breast Reconstruction Following Areola-Sparing Mastectomy

One-Stage Nipple and Breast Reconstruction Following Areola-Sparing Mastectomy

Aesthetic and Technical Refinements in Latissimus Dorsi Implant Breast Reconstruction: A 15-Year Experience

Immediate nipple reconstruction with thoracodorsal artery perforator flap in breast reconstruction by latissimus dorsi myocutaneous flap in patients with Poland's syndrome

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