Immediate One-Stage Breast Reconstruction Including Nipple-Areolar Complex

ABSTRACT

As surgical trend for breast cancer changes, the method for breast reconstruction is also changing. Due to improved diagnostic techniques and public awareness, more and more patients with breast cancer are diagnosed at earlier stage and the number of patients who undergo skin sparing mastectomy is also increasing. Skin sparing mastectomy has several advantages for immediate breast reconstruction over modified radical mastectomy. Its preservation of breast skin envelope and inframammary fold made it possible to provide more natural breast mound shape without any evidence of increased local recurrence of malignancy. Furthermore, in case of immediate breast reconstruction after modified radical mastectomy, procedures for nipple-areolar reconstruction was deferred for fear of postoperative deformation and vascular problem of the flap. This interval made patients less satisfied with the result and postoperative adjuvant treatment had to be sometimes postponed. To avoid these limitations, "one-stage" breast reconstruction including nipple-areolar complex was performed after skin sparing mastectomy. From December 1998 to March 2000, a total of 12 patients with breast cancer underwent skin-sparing mastectomies, which were followed by immediate reconstruction using our new technique. After long-term follow-up, no major complication including flap necrosis or asymmetry was found and all patients were satisfied with the results. With careful patient selection and adequate intra-operative flap tailoring, this new technique could offer lots of advantages to both surgeons and patients.