Nipple Sparing Mastectomy and Direct to Implant Breast Reconstruction, Validation of the Safe Procedure Through the Use of Laser Assisted Indocyanine Green Fluorescent Angiography

Overview

Journal Gland Surg

Publisher AME Publishing Company

Specialty Endocrinology

Date 2018 Jul 13

PMID 29998075

Citations 11

Authors

Roy De Vita

Ernesto Maria Buccheri

Affiliations

Soon will be listed here.

Abstract

Background: Nipple sparing mastectomy (NSM) is a psychologically effective and oncological safe procedure followed by immediate breast reconstruction.

Methods: Between January 2015 and September 2015 the authors conducted a retrospective review of 40 patients divided into two groups depending on breast volume and weight of mastectomy: group A, 20 patients with small breast; group B, 20 patients with medium breast for nipple sparing mastectomy and direct to implant (DTI) breast reconstruction using strict patient selection and a standardized surgical technique. The nipple areola complex/flap viability were analysed intraoperatively through the use of laser assisted indocyanine green (ICG) fluorescent angiography.

Results: A total of 44 procedures were followed-up for 24 months. Nineteen patients were assisted in DTI breast reconstruction by acellular dermal matrix (ADM) for inferior/lateral part of the implant coverage. Encouraging results are presented with a unique case of implant failure.

Conclusions: We report our retrospective experience corroborated by intraoperative laser assisted ICG fluorescent angiography to demonstrate the safety and reliability of the oncoplastic procedure proposed. We also advocate the central role of oncoplastic surgeon as "one man band" to manage breast cancer from the oncological procedure to the breast reconstruction.

Citing Articles

Diluted Indocyanine Green Angiography: A Novel Approach to Free Flap Perfusion Evaluation in Reconstructive Microsurgery.

Atmodiwirjo P, Ramadan M, Wicaksana A, Djohan M, Amanda N, Ralena N Plast Reconstr Surg Glob Open. 2024; 12(11):e6280.

PMID: 39507312 PMC: 11537560. DOI: 10.1097/GOX.0000000000006280.

Prospective Clinical Trial for Predicting Mastectomy Skin Flap Necrosis with Indocyanine Green Angiography in Implant-Based Prepectoral Breast Reconstruction.

Kim J, Han M, Hong K Aesthetic Plast Surg. 2024; 48(23):4937-4944.

PMID: 38740624 PMC: 11739317. DOI: 10.1007/s00266-024-04106-x.

Postmastectomy dual-plane submuscular-subcutaneous implant-based reconstruction: a series of 100 consecutive patients.

De Lorenzi F, Sala P, Catapano S, Mazzocconi L, Lorenzano V, Borelli F Updates Surg. 2023; 76(2):613-621.

PMID: 37964047 DOI: 10.1007/s13304-023-01683-5.

Implant-Based Breast Reconstruction after Risk-Reducing Mastectomy in BRCA Mutation Carriers: A Single-Center Retrospective Study.

Cammarata E, Toia F, Rossi M, Cipolla C, Vieni S, Speciale A Healthcare (Basel). 2023; 11(12).

PMID: 37372859 PMC: 10298386. DOI: 10.3390/healthcare11121741.

Is Using Closed Incision Negative Pressure Therapy in Reconstructive and Oncoplastic Breast Surgery Helpful in Reducing Skin Necrosis?.

Al-Ishaq Z, Rahman E, Salem F, Taj S, Mula-Hussain L, Mylvaganam S Cureus. 2023; 15(4):e38167.

PMID: 37122978 PMC: 10146378. DOI: 10.7759/cureus.38167.

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