Optimizing Aesthetic Outcomes in Breast Reconstruction After Nipple-Sparing Mastectomy

Aesthetic Surgery Journal
Mihye Choi, Jordan D Frey

Abstract

Nipple-sparing mastectomy (NSM) has been associated with improved quality of life and patient satisfaction with similar oncologic outcomes compared with traditional mastectomy techniques. By conserving the nipple-areola complex and the majority of the breast skin envelope, NSM allows for improved aesthetic outcomes after breast reconstruction. However, the technique is also associated with a steep learning curve that must be considered to achieve optimal outcomes. It is important that the plastic surgeon functions in concert with the extirpative breast surgeon to optimize outcomes because the reconstruction is ultimately dependent on the quality of the overlying mastectomy flaps. Various other factors influence the complex interplay between aesthetic and reconstructive outcomes in NSM, including preoperative evaluation, specific implant- and autologous-based considerations, as well as techniques to optimize and correct nipple-areola complex position. Management strategies for complications necessary to salvage a successful reconstruction are also reviewed. Lastly, techniques to expand indications for NSM and maximize nipple viability as well as preshape the breast are discussed. Through thoughtful preoperative planning and intr...Continue Reading

References

Nov 7, 2006·Journal of the American College of Surgeons·Virgilio SacchiniPatrick I Borgen
Apr 6, 2011·Journal of the American College of Surgeons·Cristiano BonetiV Suzanne Klimberg
Sep 5, 2014·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·H AdamJ de Boniface
Dec 3, 2015·Journal of Surgical Oncology·Jordan D FreyAmber A Guth
Jan 4, 2017·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Laurel S KarianKevin T Nini
Jul 27, 2017·Plastic and Reconstructive Surgery·Christopher R BaileyGedge D Rosson
Sep 13, 2017·Plastic and Reconstructive Surgery. Global Open·Jordan D FreyNolan S Karp
Jan 24, 2018·Aesthetic Surgery Journal·Ali A QureshiTerence M Myckatyn
Jul 15, 2018·The Surgical Clinics of North America·Caroline Jones, Rachael Lancaster
Mar 13, 2019·Plastic and Reconstructive Surgery. Global Open·Jordan D FreyNolan S Karp
Jan 28, 2020·Plastic and Reconstructive Surgery·Jordan D FreyNolan S Karp

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