A New Approach to Nipple-Sparing Mastectomy for Patients with Ptotic Breasts: A Single-Center, Retrospective Analysis of Feasibility and Treatment Outcomes
- 1Clinical Department of Surgery, Wroclaw Medical University Branch Walbrzych, 50-367 Wałbrzych, Poland
- 2Department of Surgical Oncology, Alfred Sokolowski’s Specialistic Hospital in Walbrzych, 58-309 Wałbrzych, Poland
- 3Student Research Group SKN, Wroclaw Medical University, 50-367 Wrocław, Poland
Abstract
Background/Objectives: Subcutaneous mastectomies with immediate implant-based reconstruction have become widely performed procedures worldwide. Patients with small, non-ptotic breasts are candidates for procedures that do not involve skin reduction (NSM), whereas those with macromastia and significant ptosis undergo procedures involving the excision of excess skin (SRM). However, there remains a small group of patients for whom neither of these two options is ideal. We have developed a technique for reducing the implant pocket without excising excess skin, specifically designed for this group of patients. Methods: We conducted a retrospective analysis of 298 patients (419 breasts) who underwent surgery at our center between 2016 and 2025, comparing the method we described (NSM-LR) with NSM and SRM. A statistical analysis was performed. We evaluated oncological outcomes, complication rates, and implant loss. Satisfaction with the reconstructed breast was assessed using the Breast-Q questionnaire. Results: All cases were R0 resection. Locoregional recurrence was as follows: NSM—3.1%, NSM-LR—9.1%, and SRM—5.4% (p = 0.2363). Major complications were as follows: NSM—25.4%, NSM-LR—21.2%, and SRM—33.8% (p = 0.0887). Implant loss was as follows: NSM—7.6%, NSM-LR—10%, and SRM—17.6% (p = 0.0155). Breast Q score was as follows: NSM—78, NSM-LR—82, and SRM–75. Conclusions: NSM-LR can be a reasonable option for selected patients requiring a subcutaneous mastectomy.
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BibTeX
@article{pyka2026approach,
title = {{A New Approach to Nipple-Sparing Mastectomy for Patients with Ptotic Breasts: A Single-Center, Retrospective Analysis of Feasibility and Treatment Outcomes}},
author = {Paweł Pyka and Andrzej Frejnagel and Dzmitry Karkotka and Olga Nowak},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208026},
url = {https://www.mdpi.com/2077-0383/15/20/8026},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A New Approach to Nipple-Sparing Mastectomy for Patients with Ptotic Breasts: A Single-Center, Retrospective Analysis of Feasibility and Treatment Outcomes
AU - Paweł Pyka
AU - Andrzej Frejnagel
AU - Dzmitry Karkotka
AU - Olga Nowak
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208026
UR - https://www.mdpi.com/2077-0383/15/20/8026
AB - Background/Objectives: Subcutaneous mastectomies with immediate implant-based reconstruction have become widely performed procedures worldwide. Patients with small, non-ptotic breasts are candidates for procedures that do not involve skin reduction (NSM), whereas those with macromastia and significant ptosis undergo procedures involving the excision of excess skin (SRM). However, there remains a small group of patients for whom neither of these two options is ideal. We have developed a technique for reducing the implant pocket without excising excess skin, specifically designed for this group of patients. Methods: We conducted a retrospective analysis of 298 patients (419 breasts) who underwent surgery at our center between 2016 and 2025, comparing the method we described (NSM-LR) with NSM and SRM. A statistical analysis was performed. We evaluated oncological outcomes, complication rates, and implant loss. Satisfaction with the reconstructed breast was assessed using the Breast-Q questionnaire. Results: All cases were R0 resection. Locoregional recurrence was as follows: NSM—3.1%, NSM-LR—9.1%, and SRM—5.4% (p = 0.2363). Major complications were as follows: NSM—25.4%, NSM-LR—21.2%, and SRM—33.8% (p = 0.0887). Implant loss was as follows: NSM—7.6%, NSM-LR—10%, and SRM—17.6% (p = 0.0155). Breast Q score was as follows: NSM—78, NSM-LR—82, and SRM–75. Conclusions: NSM-LR can be a reasonable option for selected patients requiring a subcutaneous mastectomy.
SN - 2077-0383
ER -