Summary
Background
Nipple–areola complex sparing mastectomy (NSM) with immediate implant reconstruction
has been recently introduced for breast cancer patients who are not candidates for
breast preserving surgery. As the cosmetic results in moderately ptotic breasts may
not be optimal, a modified NSM with a periareolar pexy (PP-NSM) was introduced at
our Institution. Patients selection criteria and complication rates of PP-NSM were
prospectively recorded and compared with those of the classical NSM.
Results
Over a period of 11 months, 22 PP-NSMs and 35 NSMs were performed. The mean jugular–nipple
distance was significantly longer in the PP-NSM as compared with the NSM (22.6 vs.
19.6 cm; p=0.000), whereas the mean inframammary fold–areola distance was superimposable (5.4 cm). The periareolar mastopexy led to a mean cranial transposition of the nipple-areola
complex (NAC) of 2.2 cm (range 1.5–4 cm). Mean breast weight was significantly higher in the PP-NSM as compared with the
NSM cohort (336 vs. 236 g; p=0.003). The only case of total NAC necrosis occurred in the PP-NSM group. Partial
NAC necrosis was slightly more frequent in the PP-NSM than in the NSM group (13.6%
vs. 2.9%%; p=n.s.), possibly due to the higher percentage of smokers (41.0% vs. 14.0%; p=0.05). Early cosmetic results were good to excellent from the surgeon’s and the patient’s
point of view in over 80% of the cases.
Conclusions
PP-NSM allows good cosmetic results and low complication rates in patients with moderately
ptotic breasts requiring a mastectomy. In particular, PP-NSM seems to be a good option
for women at high risk for developing breast cancer and for selected patients affected
by non-locally advanced breast cancer.
Keywords
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Article info
Publication history
Published online: October 17, 2011
Accepted:
September 17,
2011
Received:
March 15,
2011
Footnotes
☆Meetings at which the article has been presented: none.
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
