Nipple-Sparing Mastectomy and Immediate Free-Flap Reconstruction in the Large Ptotic Breast
2012; Lippincott Williams & Wilkins; Volume: 69; Issue: 4 Linguagem: Inglês
10.1097/sap.0b013e31824a45be
ISSN1536-3708
AutoresLisa Schneider, Constance M. Chen, Alan Stolier, Richard L. Shapiro, Christina Y. Ahn, Robert J. Allen,
Tópico(s)Reconstructive Facial Surgery Techniques
ResumoBecause of increased risk for nipple necrosis, many surgeons believe large ptotic breasts to be a relative contraindication to nipple-sparing mastectomy (NSM). A retrospective review was performed on 85 consecutive patients who underwent NSM with 141 immediate perforator free-flap breast reconstructions. We analyzed the subset of patients with large ptotic breasts, defined as cup size C or greater, sternal notch to nipple distance greater than 24 cm and grade 2 or 3 breast ptosis. Of the 85 patients, 19 fit the inclusion criteria. Breast cup size ranged from 34C to 38DDD. There was 1 case of nipple necrosis in the patient with previous breast radiation (5%), 1 hematoma (5%), and no flap losses. Five (26%) patients underwent subsequent mastopexy or breast reduction, a mean of 6.6 months after the primary procedure. We demonstrate that NSM and free-flap breast reconstruction can be safely and reliably performed in selected patients.
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