Comparison of Outcomes between Direct-to-Implant Breast Reconstruction Following Nipple-Sparing Mastectomy through Inframammary Fold Incision versus Noninframammary Fold Incision.
10.4048/jbc.2018.21.2.213
- Author:
Tai Suk ROH
1
;
Jae Yoon KIM
;
Bok Ki JUNG
;
Joon JEONG
;
Sung Gwe AHN
;
Young Seok KIM
Author Information
1. Department of Plastic & Reconstructive Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. psyskim@yuhs.ac
- Publication Type:Original Article
- Keywords:
Breast implants;
Mammaplasty;
Mastectomy
- MeSH:
Breast Implants;
Breast Neoplasms;
Breast*;
Cicatrix;
Contracture;
Female;
Hematoma;
Humans;
Mammaplasty*;
Mastectomy*;
Necrosis;
Postoperative Complications;
Recurrence;
Reoperation;
Seroma;
Skin
- From:Journal of Breast Cancer
2018;21(2):213-221
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: In properly selected patients with breast cancer, nipple-sparing mastectomy (NSM) is generally considered safe by oncologic standards. We examined two groups of patients who underwent direct-to-implant (DTI) reconstruction after NSM, comparing complications encountered, revision rates, and aesthetic outcomes. The patients were stratified based on type of surgical incision and assigned to inframammary fold (IMF) and non-IMF groups. METHODS: We investigated 141 patients (145 breasts) subjected to NSM and immediate DTI reconstruction between 2013 and 2016. A total of 62 breasts (in 58 patients) were surgically removed via IMF incisions, with the other 83 breasts (in 83 patients) removed by non-IMF means. RESULTS: Complications associated with IMF (n=62) and non-IMF (n=83) incisions were as follows: skin necrosis (IMF, 9; non-IMF, 18); hematoma (IMF, 3; non-IMF, 4); seroma (IMF, 8; non-IMF, 4); mild capsular contracture (IMF, 4; non-IMF, 7); and tumor recurrence (IMF, 2; non-IMF, 8). Surgical revisions were counted as duplicates (IMF, 18; non-IMF, 38). Aesthetic outcomes following IMF incisions were rated as very good (44.2%), good (23.1%), fair (23.1%), or poor (9.6%). CONCLUSION: IMF incision enables complete preservation of the nipple-areolar complex, yielding superior aesthetic results in immediate DTI breast reconstruction after NSM. The nature of incision used had no significant impact on postoperative complications or reoperation rates and had comparable oncologic safety to that of non-IMF incisions. IMF incisions produced the least visible scarring and did not affect breast shape. Most patients were satisfied with the aesthetic outcomes.
