Division of Plastic Surgery and Breast Surgery Group, University of São Paulo School of Medicine, São Paulo, Brazil; Mastology Department, Hospital Sírio-Libanês São Paulo, São Paulo, Brazil.
Breast. 2009 Dec;18(6):356-67. doi: 10.1016/j.breast.2009.09.008.
Although the biodimensional anatomical expander-implant system (BEIS) is a reliable technique, little information has been available regarding outcome following nipple-areola sparing mastectomy (NSM). To perform the resection of glandular tissue, while improving the surgical access and maintaining the nipple-areola vascularization we have developed a new approach for NSM based on the double concentric periareolar incision (DCPI). The purpose of this study is to analyze the feasibility, surgical planning and its outcome following NSM. 18 patients underwent NSM reconstructions. Mean time of follow-up was 29 months. The technique was indicated in patients with small/moderate volume breasts. Flap complications were evaluated and information on aesthetic results and patient satisfaction were collected. 83.3% had tumors measuring 2cm or less (T1) and 72.1% were stage 0 and I. All patients presented peripherally tumors located (at least 5cm from the nipple). Skin complications occurred in 11.1%. One patient (5.5%) presented small skin necrosis and a wound dehiscence was observed in one patient (5.5%). The aesthetic result was good/very good in 94.4 percent and the majority of patients were very satisfied/satisfied. No local recurrences were observed. All complications except one were treated by a conservative approach. DCPI-BEIS is a simple and reliable technique for NSM reconstruction. The success depends on patient selection, coordinated planning with the oncologic surgeon and careful intra-operative and post-operative management.
虽然生物维度解剖扩张器-植入物系统（BEIS）是一种可靠的技术，但关于保留乳头乳晕的乳房切除术（NSM）后的结果，信息很少。为了切除腺体组织，同时改善手术通道并保持乳头乳晕的血管化，我们开发了一种基于双同心乳晕切口（DCPI）的新的 NSM 方法。本研究的目的是分析 NSM 的可行性、手术规划及其结果。18 名患者接受了 NSM 重建。平均随访时间为 29 个月。该技术适用于乳房体积小/中等的患者。评估皮瓣并发症，并收集有关美容效果和患者满意度的信息。83.3%的患者肿瘤直径为 2cm 或更小（T1），72.1%为 0 期和 I 期。所有患者的肿瘤均位于乳晕周围（至少距乳晕 5cm）。11.1%的患者出现皮肤并发症。1 例（5.5%）患者出现小面积皮肤坏死，1 例（5.5%）患者出现伤口裂开。94.4%的美容效果良好/非常好，大多数患者非常满意/满意。未观察到局部复发。除 1 例外，所有并发症均采用保守方法治疗。DCPI-BEIS 是一种用于 NSM 重建的简单可靠的技术。成功取决于患者选择、与肿瘤外科医生的协调规划以及术中、术后的精心管理。
