Expanded Algorithm and Updated Experience with Breast Reconstruction Using a Staged Nipple-Sparing Mastectomy following Mastopexy or Reduction Mammaplasty in the Large or Ptotic Breast.

MedStar author(s):
Citation: Plastic & Reconstructive Surgery. 143(4):688e-697e, 2019 Apr.PMID: 30921113Institution: MedStar Washington Hospital CenterDepartment: Surgery/Plastic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Mammaplasty/mt [Methods] | *Mastectomy/mt [Methods] | *Nipples/su [Surgery] | *Organ Sparing Treatments/mt [Methods] | Adult | Aged | Algorithms | Humans | Middle Aged | Operative Time | Prospective Studies | Reoperation/sn [Statistics & Numerical Data] | Retrospective Studies | Treatment OutcomeYear: 2019ISSN:
  • 0032-1052
Name of journal: Plastic and reconstructive surgeryAbstract: BACKGROUND: Staged nipple-sparing mastectomy following mastopexy or reduction mammaplasty was first described in 2011 by Spear et al. to expand the indications for nipple-sparing mastectomy to women with large or ptotic breasts. Since that time, the authors have revised their treatment algorithm and technique to enhance oncologic safety and improve wound healing complications.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.CONCLUSIONS: The authors offer their updated treatment algorithm for a staged approach to nipple-sparing mastectomy for patients with macromastia or grade II or III ptosis. Their results build on previously published reports demonstrating the safety and efficacy of this approach for nipple preservation and oncologic management in this patient population.METHODS: An institutional review board-approved retrospective review was undertaken of all patients undergoing staged nipple-sparing mastectomy following mastopexy or reduction mammaplasty at a single institution from July of 2011 through July of 2016. Management followed an updated treatment protocol to improve surgical and oncologic outcomes.RESULTS: Twenty-six patients (50 breasts) were identified who underwent staged nipple-sparing mastectomy. Five breasts (10 percent) required reoperation for a complication such as infection or tissue necrosis. Two devices (4 percent), both in the therapeutic cohort, required explantation because of infection. Skin flap necrosis and nipple-areola complex necrosis were each seen in two breasts (4 percent). Infection was seen in four breasts (8 percent), and wound healing complications were seen in only two breasts (4 percent).All authors: Economides JM, Graziano F, Pittman TA, Tousimis E, Willey SFiscal year: FY2019Digital Object Identifier: Date added to catalog: 2019-05-21
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 30921113

BACKGROUND: Staged nipple-sparing mastectomy following mastopexy or reduction mammaplasty was first described in 2011 by Spear et al. to expand the indications for nipple-sparing mastectomy to women with large or ptotic breasts. Since that time, the authors have revised their treatment algorithm and technique to enhance oncologic safety and improve wound healing complications.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

CONCLUSIONS: The authors offer their updated treatment algorithm for a staged approach to nipple-sparing mastectomy for patients with macromastia or grade II or III ptosis. Their results build on previously published reports demonstrating the safety and efficacy of this approach for nipple preservation and oncologic management in this patient population.

METHODS: An institutional review board-approved retrospective review was undertaken of all patients undergoing staged nipple-sparing mastectomy following mastopexy or reduction mammaplasty at a single institution from July of 2011 through July of 2016. Management followed an updated treatment protocol to improve surgical and oncologic outcomes.

RESULTS: Twenty-six patients (50 breasts) were identified who underwent staged nipple-sparing mastectomy. Five breasts (10 percent) required reoperation for a complication such as infection or tissue necrosis. Two devices (4 percent), both in the therapeutic cohort, required explantation because of infection. Skin flap necrosis and nipple-areola complex necrosis were each seen in two breasts (4 percent). Infection was seen in four breasts (8 percent), and wound healing complications were seen in only two breasts (4 percent).

English

Powered by Koha