CC BY-NC 4.0 · Arch Plast Surg 2013; 40(05): 553-558
DOI: 10.5999/aps.2013.40.5.553
Original Article

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

Hye Ri Kim
Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea
,
Jin Soo Lim
Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea
,
Sue Min Kim
Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea
,
Sung No Jung
Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea
,
Gyeol Yoo
Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea
,
Eun Young Rha
Department of Plastic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea
› Institutsangaben

Background Skin-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.

Methods Among 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.

Results During 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.

Conclusions Since 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.



Publikationsverlauf

Eingereicht: 27. März 2013

Angenommen: 04. Juli 2013

Artikel online veröffentlicht:
01. Mai 2022

© 2013. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Rosenqvist S, Sandelin K, Wickman M. Patients' psychological and cosmetic experience after immediate breast reconstruction. Eur J Surg Oncol 1996; 22: 262-266
  • 2 Carlson GW, Bostwick 3rd J, Styblo TM. et al. Skin-sparing mastectomy: oncologic and reconstructive considerations. Ann Surg 1997; 225: 570-575
  • 3 Hidalgo DA. Aesthetic refinement in breast reconstruction: complete skin-sparing mastectomy with autogenous tissue transfer. Plast Reconstr Surg 1998; 102: 63-70
  • 4 Toth BA, Forley BG, Calabria R. Retrospective study of the skin-sparing mastectomy in breast reconstruction. Plast Reconstr Surg 1999; 104: 77-84
  • 5 Mustonen P, Lepisto J, Papp A. et al. The surgical and oncological safety of immediate breast reconstruction. Eur J Surg Oncol 2004; 30: 817-823
  • 6 Simmons RM, Brennan M, Christos P. et al. Analysis of nipple/areolar involvement with mastectomy: can the areola be preserved?. Ann Surg Oncol 2002; 9: 165-168
  • 7 Mathes SJ, Ueno CM. Reconstruction of the nipple-areola complex. In: Mathes SJ, Hentz VR. Plastic surgery. 2nd ed. Philadelphia: Saunders Elsevier; 2006: 791-818
  • 8 Mori H, Hata Y. Modified C-V flap in nipple reconstruction. J Plast Reconstr Aesthet Surg 2008; 61: 1109-1110
  • 9 Salgarello M, Visconti G, Barone-Adesi L. Nipple-sparing mastectomy with immediate implant reconstruction: cosmetic outcomes and technical refinements. Plast Reconstr Surg 2010; 126: 1460-1471
  • 10 McCarthy CM, Klassen AF, Cano SJ. et al. Patient satisfaction with postmastectomy breast reconstruction: a comparison of saline and silicone implants. Cancer 2010; 116: 5584-5591
  • 11 Pusic AL, Klassen AF, Scott AM. et al. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 2009; 124: 345-353
  • 12 Simmons RM, Adamovich TL. Skin-sparing mastectomy. Surg Clin North Am 2003; 83: 885-899
  • 13 Giacometti L, Montagna W. The nipple and the areola of the human female breast. Anat Rec 1962; 144: 191-197
  • 14 Simmons RM, Hollenbeck ST, Latrenta GS. Two-year follow-up of areola-sparing mastectomy with immediate reconstruction. Am J Surg 2004; 188: 403-406
  • 15 Kissin MW, Kark AE. Nipple preservation during mastectomy. Br J Surg 1987; 74: 58-61
  • 16 Cense HA, Rutgers EJ, Lopes Cardozo M. et al. Nipple-sparing mastectomy in breast cancer: a viable option?. Eur J Surg Oncol 2001; 27: 521-526
  • 17 Simmons RM, Hollenbeck ST, Latrenta GS. Areola-sparing mastectomy with immediate breast reconstruction. Ann Plast Surg 2003; 51: 547-551
  • 18 Hammond DC. Prophylactic simple mastectomy and reconstruction, including prosthetic, latissimus, and transverse rectus abdominus myocutaneous flap techniques. In: Spear SL, Willey SC, Robb GL. et al. Surgery of the breast: principles and art. Philadelphia: Lippincott Williams & Wilkins; 2006: 346-348
  • 19 Kim JT, Kim CY, Cha JH. et al. Immediate nipple reconstruction in breast reconstruction with TRAM free flap. J Korean Soc Plast Reconstr Surg 2005; 32: 76-84
  • 20 Delay E, Mojallal A, Vasseur C. et al. Immediate nipple reconstruction during immediate autologous latissimus breast reconstruction. Plast Reconstr Surg 2006; 118: 1303-1312
  • 21 Ma G, Richardson H, Pacella SJ. et al. Single-stage breast reconstruction following areola-sparing mastectomy. Plast Reconstr Surg 2009; 123: 1414-1417
  • 22 Horikawa T, Norris DA, Yohn JJ. et al. Melanocyte mitogens induce both melanocyte chemokinesis and chemotaxis. J Invest Dermatol 1995; 104: 256-259
  • 23 Mohamed SA, Parodi PC. A modified technique for nippleareola complex reconstruction. Indian J Plast Surg 2011; 44: 76-80
  • 24 Craig ES, Walker ME, Salomon J. et al. Immediate nipple reconstruction utilizing the DIEP flap in areola-sparing mastectomy. Microsurgery 2013; 33: 125-129