Hindawi Publishing Corporation
Plastic Surgery International
Volume 2013, Article ID 406375, 5 pages
http://dx.doi.org/10.1155/2013/406375
Research Article
Skin-Sparing Mastectomy with Immediate Breast and Nipple
Reconstruction: A New Technique of Nipple Reconstruction
Raffaele Serra,
1
Anna Maria Miglietta,
2
Sergio Abonante,
2
Vincent Giordano,
3
Gianluca Buffone,
1
and Stefano de Franciscis
1
1
Department of Medical and Surgical Science, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
2
Breast Unit, Annunziata Hospital, 87100 Cosenza, Italy
3
Plastic Surgery Unit, Annunziata Hospital, 87100 Cosenza, Italy
Correspondence should be addressed to Raffaele Serra; rserra@unicz.it
Received 24 August 2012; Revised 17 December 2012; Accepted 22 December 2012
Academic Editor: Lee L. Q. Pu
Copyright © 2013 Raffaele Serra et al. is is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. Most women with breast cancer today can be managed with breast conservation; however, some women still require
mastectomy for treatment of their disease. Skin-sparing mastectomy (SSM) with immediate reconstruction has emerged as a favor-
able option for many of these patients. e authors combined the SSM technique with the preservation of a small part of the areola
with immediate nipple together with with breast reconstruction. Methods. In an 8-year-period 155 female patients (age: 20–52 years
old; mean age: 37.5 years) with extensive ductal intraepithelial neoplasia (DIN) or invasive breast cancer were treated with areola
skin sparing mastectomy with immediate nipple and breast reconstruction. Patients were followed up prospectively by the breast
surgeon, the plastic surgeon, and the oncologist for complications and recurrence. Results. Aer treatment, only 2 cases (1.29%)
had a local recurrence. 8 out of 155 (5.5%) patients developed early complications (infections, seroma, haematoma), and 5 out of
155 patients (3.22%) developed delayed complications (implant rotation, aestethic deterioration) in the post operative time period.
e �nal aesthetic outcome was judged as positive in 150 out of 155 patients (96.78%). Conclusion. In our experience, immediate
nipple reconstruction aer skin-sparing mastectomy is a technically feasible procedure which can give excellent cosmetic results.
1. Introduction
Mastectomy represents the treatment of choice for approxi-
mately one-third of women with breast cancer due to aggres-
sive, extensive, or multicentric tumour growth, contraindica-
tions for radiotherapy, or following the patient’s wish.
To most of these cases, immediate breast reconstruction
(IBR) can be offered to overcome the psychological burden
caused by the dis�gurement resulting from the loss of the
breast [1].
Skin-sparing mastectomy (SSM) can be followed by
immediate breast reconstruction (IBR) using autologous
tissue and/or prosthetic implants, and this approach has been
advocated as an effective treatment option for patients with
early-stage breast cancer which is not amenable to breast-
conserving therapy [2–4].
e presence of the nipples seems fundamental to mark-
ing the identity of the breast. Based on the psychological
impact of nipple-areola complex (NAC) removal in classical
mastectomy techniques, several authors have evaluated the
risk of nipple areola involvement and investigated the pos-
sibility of nipple areola preservation, but the risk of cancer
recurrence in the breast tissue preserved beneath the NAC for
the blood supply is considered a major reason to avoid NAC
conservation during the mastectomy [5].
e authors combined the SSM technique with the
preservation of a small part of the areola with immediate
nipple and breast reconstruction.
e most interesting part of the method used at the
author’s institution is precisely the particular new tech-
nique of nipple reconstruction that has not been previously
described.
e authors reports their experience carried out in the
last eight years in order to evaluate the oncological safety,
postoperative morbidity and patients’ satisfaction with this
technique.