PMID- 37621816
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230826
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 7
DP  - 2023 Jul
TI  - Outcomes of Nipple-Sparing Mastectomy in the Ptotic and Non-Ptotic Breast with 
      Staged-Immediate Reconstruction Timing and Pre-Pectoral, Direct-to-Implant 
      Technique.
PG  - e42363
LID - 10.7759/cureus.42363 [doi]
LID - e42363
AB  - Background and objectives Proven to be oncologically safe, nipple-sparing 
      mastectomy (NSM) preserves the entire breast skin envelope and is associated with 
      higher patient satisfaction. However, breast ptosis is a relative 
      contraindication to NSM, limiting who it is offered to. Direct-to-implant (DTI) 
      breast reconstruction eliminates tissue expansion and shortens the reconstructive 
      process but may be associated with mastectomy skin flap compromise after the 
      placement of full-volume implants. Staged-immediate (SI) reconstruction initiates 
      reconstruction two to three weeks after mastectomy. This timing and its use in 
      DTI pre-pectoral (PP) breast reconstruction have not been reported. We aim to 
      describe the outcomes of SI DTI PP reconstruction following NSM of ptotic and 
      non-ptotic breasts. Methods Retrospective analysis utilizing descriptive 
      statistics was completed evaluating patients who underwent nipple-sparing 
      mastectomy with staged-immediate, pre-pectoral, direct-to-implant reconstruction 
      by the senior author over a three-year period. Results and conclusions With SI 
      timing, the majority of mastectomy-related problems occurred prior to implant 
      placement, likely mitigating their effects on reconstruction following NSM, 
      regardless of ptosis grade. Although a second procedure is needed for this 
      reconstructive timing variation, over 50% of women achieved reconstruction 
      completion at implant placement without further revision. These findings support 
      the utility of SI timing in PP DTI reconstruction following NSM.
CI  - Copyright (c) 2023, Duet et al.
FAU - Duet, Mary
AU  - Duet M
AD  - Plastic and Reconstructive Surgery, Atrium Health Wake Forest Baptist Medical 
      Center, Winston-Salem, USA.
FAU - Pestana, Ivo A
AU  - Pestana IA
AD  - Plastic and Reconstructive Surgery, Atrium Health Wake Forest Baptist Medical 
      Center, Winston-Salem, USA.
LA  - eng
PT  - Journal Article
DEP - 20230724
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10445411
OTO - NOTNLM
OT  - breast ptosis
OT  - breast reconstruction
OT  - breast reconstruction timing
OT  - comparative study
OT  - direct to implant technique
OT  - implant breast reconstruction
OT  - nipple-sparing mastectomy
OT  - patient outcomes
OT  - prepectoral breast reconstruction
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/08/25 06:42
MHDA- 2023/08/25 06:43
PMCR- 2023/07/24
CRDT- 2023/08/25 03:52
PHST- 2023/07/24 00:00 [accepted]
PHST- 2023/08/25 06:43 [medline]
PHST- 2023/08/25 06:42 [pubmed]
PHST- 2023/08/25 03:52 [entrez]
PHST- 2023/07/24 00:00 [pmc-release]
AID - 10.7759/cureus.42363 [doi]
PST - epublish
SO  - Cureus. 2023 Jul 24;15(7):e42363. doi: 10.7759/cureus.42363. eCollection 2023 
      Jul.