Levy Jerry, Bosc Romain, Warren Noel, Rebecca Sabban, Dao Thu Ha, Hersant Barbara, Meningaud Jean-Paul
Ann Plast Surg. 2018 Jun;80(6):639-643. doi: 10.1097/SAP.0000000000001404.
The morphological result of nipple-areola complex (NAC) reconstruction may be disappointing for patients who undergo skin-sparing mastectomies and immediate breast reconstruction, followed by secondary reconstruction of the nipple-areola complex.The aim of this study was to analyze patient satisfaction after nipple-sparing mastectomy and immediate breast reconstruction with a deep inferior epigastric perforator flap.
Our retrospective study involved all patients who underwent an immediate breast reconstruction after unilateral mastectomy with conservation of the NAC. The following three kinds of surgical approach were used: mastectomy with periareolar incision, mastectomy with hemiperiareolar incision and lateral extension, and mastectomy with inverted-T mammoplasty incision. Our study was based on a survey using a standardized questionnaire and a Likert scale to report patient satisfaction on the basis of criteria defined by the investigators.
We evaluated 17 patients. All reconstruction patients were satisfied or very satisfied with the overall aesthetic appearance, projection, and volume as well as the appearance of scarring on the reconstructed breast. None of our patients reported dissatisfaction in response to the criteria under evaluation. A periareolar incision was used most often to perform the mastectomy (10 patients). Partial NAC necrosis was observed in five patients, without negatively influencing their perception of the morphological outcome of their reconstruction.
Immediate breast reconstruction using a deep inferior epigastric perforator free flap after nipple-sparing mastectomies met with a high rate of general satisfaction among patients and resulted in a low rate of nipple-areola complex necrosis.
对于接受保乳皮肤切除术并即刻进行乳房重建，随后再进行乳头乳晕复合体二期重建的患者而言，乳头乳晕复合体（NAC）重建的形态学结果可能不尽人意。本研究旨在分析保留乳头的乳房切除术后即刻采用腹壁下深动脉穿支皮瓣进行乳房重建的患者满意度。
我们的回顾性研究纳入了所有接受单侧乳房切除并保留NAC后即刻进行乳房重建的患者。采用了以下三种手术方式：乳晕周围切口乳房切除术、半乳晕切口加外侧延长乳房切除术以及倒T形乳房成形术切口乳房切除术。我们的研究基于一项调查，该调查使用标准化问卷和李克特量表，根据研究者定义的标准报告患者满意度。
我们评估了17例患者。所有重建患者对整体美学外观、突出度、体积以及重建乳房上的瘢痕外观均感到满意或非常满意。我们的患者在评估标准方面均未报告不满意情况。最常采用乳晕周围切口进行乳房切除术（10例患者）。5例患者观察到部分NAC坏死，但这并未对他们对重建形态学结果的认知产生负面影响。
保留乳头的乳房切除术后即刻采用腹壁下深动脉穿支游离皮瓣进行乳房重建，患者总体满意度较高，乳头乳晕复合体坏死率较低。
