Nipple sparing mastectomy and breast reconstruction
When is this procedure indicated?
NSM followed by prepectoral implant-based reconstruction is indicated as a therapeutic procedure in patients who are diagnosed with breast cancer and as a risk-reducing procedure in women at high-risk for developing a breast cancer in the future due to genetic mutations or personal characteristics (i.e. previous irradiation, contralateral breast cancer diagnosis.
How is it performed?
NSM with prepectoral reconstruction is performed under general anesthesia and is carried out by removing all the breast tissue and leaving the nipple, the areola and the breast skin. In patients with breast cancer the tissue beneath the nipple is checked for breast cancer and if cancer is detected the nipple-areola complex is excised. Breast implants are placed in the pocket where the glandular tissue was removed just over the pectoralis major without impairing the muscle neither prolonging surgery with a more invasive procedure. On drain per breast is placed.
Recovery after NSM and prepectoral implant-based breast reconstruction is relatively fast as the muscle remains "untouched". The patient is generally discharged during the second postoperative day and within two weeks the drains are usually removed.
Intraoperative or postoperative bleeding, infection, dehiscence, need for re-intervention due to bleeding or positive margins, keloids, breast asymmetry, low satisfaction for cosmetic results, necrosis of the skin or of the nipple-areola complex, seroma eventually requiring needle aspiration, local pain, capsular contracture, breast implant-associated anaplastic large cell lymphoma.