Dehbozorgi Mohammad, Fazelzadeh Afsoon, Mohammadi Aliakbar, Tahmasebi Sedighe, Paul Malcolm D
Department of Plastic and Reconstructive Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Oncosurgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
World J Plast Surg. 2025;14(1):43-51. doi: 10.61186/wjps.14.1.43.
Nipple sparing mastectomy has become a preferred method in breast cancer patients but safety of this procedure in large ptotic breasts needs to be documented to broaden its application. We aimed to assess complication rates of patients undergoing NSM and immediate implant-based reconstruction with skin reduction to determine the safety of reduction in this patient group.
Patient with breast cancer and ptotic breasts whom received nipple sparing mastectomy and immediate implant-based breast reconstructions were analyzed, operated between April 2020 to last month of 2023 in Shiraz, Iran. Post-operative complications were recorded and analyzed.
The mean age and BMI of patients were 40.76 ± 5.0 and 23.72 ± 3.27 year, respectively. The median post-operative24 months (min 14, max 34). None of patients had disease recurrence. The most common complication was the flap full thickness necrosis, occurring in a total of 7 (20%) breasts. The incidence of full thickness necrosis was just seen in patients with ptosis grade III, and the most common site for the necrosis was the suture line [4/7 (12%)]. The other 3 patients had full thickness partial necrosis of NAC. We did not have any complete NAC necrosis.
Nipple sparing mastectomy and immediate implant insertion in ptotic breasts, is a valuable method of reconstruction with acceptable rate of complications.
保留乳头的乳房切除术已成为乳腺癌患者的首选方法，但该手术在乳房重度下垂患者中的安全性需要得到证实，以扩大其应用范围。我们旨在评估接受保留乳头乳房切除术及同期植入物乳房重建并缩皮的患者的并发症发生率，以确定该患者群体缩皮的安全性。
对2020年4月至2023年最后一个月在伊朗设拉子接受保留乳头乳房切除术及同期植入物乳房重建的乳腺癌伴乳房下垂患者进行分析。记录并分析术后并发症。
患者的平均年龄和体重指数分别为40.76±5.0岁和23.72±3.27。术后中位时间为24个月（最短14个月，最长34个月）。所有患者均无疾病复发。最常见的并发症是皮瓣全层坏死，共7例（20%）乳房出现该情况。全层坏死仅见于III度下垂患者，坏死最常见的部位是缝线处[4/7（12%）]。另外3例患者乳晕复合体出现全层部分坏死。我们没有出现任何乳晕复合体完全坏死的情况。
对于乳房下垂患者，保留乳头乳房切除术及同期植入假体是一种有价值的重建方法，并发症发生率可接受。
