Search Our Scientific Publications & Authors

J Breast Cancer 2021 Apr 29. Epub 2021 Apr 29.

Department of Plastic and Reconstructive Surgery, Korea University Medical Center, Seoul, Korea.

Purpose: Women with large and/or ptotic breasts are generally not considered candidates for nipple-sparing mastectomy because of concerns regarding the high incidence of postoperative complications including ischemic complications. Therefore, we adopted a vertical skin resection technique for nipple-sparing mastectomy, and obtained satisfactory results following immediate autologous breast reconstruction. In this study, we aimed to describe our operative technique and review its outcomes. Read More

Aesthetic Plast Surg 2021 Jun 11. Epub 2021 Jun 11.

Clinical lead in microsurgical breast reconstruction, St Helen and Knowsley Teaching Hospital NHS Trust, Liverpool, United Kingdom.

Bioact Mater 2021 Dec 19;6(12):4640-4653. Epub 2021 May 19.

San Rossore Breast Unit, Pisa 56122, Italy.

Breast reconstruction is rapidly evolving, thanks to the growing acceptance of synthetic meshes as innovative biomaterials. 276 patients undergoing mastectomy (total of 328 mastectomies) were analyzed in a retrospective observational study to evaluate the pre-pectoral immediate breast reconstruction (IBR) using an implant wrapped with Titanium-Coated Polypropylene Mesh (TCPM) vs. patients treated with tissue expander (TE), equally placed pre-pectorally (and wrapped with the same TCPM in 74. Read More

J Plast Reconstr Aesthet Surg 2021 Apr 18. Epub 2021 Apr 18.

Surgical Oncology, The University of Massachusetts Medical School, Worcester, MA, United States.

Purpose: This report presents the medial pillar island flap technique of oncoplastic breast reconstruction of central defects that involve the nipple-areola complex.

Methods: The procedure was performed in patients who presented with inferior pole redundancy using a vertical mammaplasty pattern. The flap was designed utilizing the territory of the lower pole as an island flap pedicled by the internal mammary artery perforators surrounded by the soft tissue of the medial pillar. Read More

Aesthet Surg J 2021 05;41(6):NP346-NP354

Department of Plastic Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.

Background: Understanding the main blood supply to the nipple-areola complex (NAC) is important for breast plastic surgery. However, previous reports have involved studies of cadavers and small sample sizes.

Objectives: This study aimed to identify and classify the in vivo blood supply to the NAC based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Read More

Adv Exp Med Biol 2021 ;1187:567-590

Hyanyang University College of Medicine, Ansan, Gyeonggi-do, South Korea.

Endoscopic oncoplastic breast surgery represents a minimal invasive approach with the aim of both safe excision of cancer and preserving the breast shape. It has less noticeable scar, excellent cosmetic outcomes, high patient satisfaction rate. Recently, relative long-term follow-up results have been reported to be very safe (Soybir and Fukuma, J Breast Health 11:52-58, 2015; Fan et al. Read More

Plast Reconstr Surg 2021 May;147(5):743e-748e

From the Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine; Twin Cities Plastic Surgery; Section of Plastic Surgery, Virginia Commonwealth University College of Medicine-Inova Branch; and the National Center for Plastic Surgery.

Background: Prepectoral reconstruction using prosthetic devices has demonstrated a notable increase in popularity and confers a number of advantages over subpectoral placement, including minimal animation, no pain secondary to muscle spasm, and less device displacement or malposition. As such, more women with implants in the dual-plane position are seeking a remedy for animation deformities, chronic pain caused by muscle spasm, and implant malposition. The purpose of this study was to review outcomes following the conversion from subpectoral to prepectoral implant placement. Read More

Plast Reconstr Surg Glob Open 2021 Apr 15;9(4):e3539. Epub 2021 Apr 15.

Northside Hospital Gwinnett, Northside Gwinnett Surgical Associates, Lawrenceville, Ga.

Patients with central breast cancers historically underwent mastectomy, as the aesthetic implications of removing the nipple-areola complex and central breast tissue left disfiguring defects after breast conservation. The introduction of oncoplastic techniques allowed for central lumpectomies in ptotic patients, as the excess skin and gland could be mobilized centrally to fill the defect and even immediately reconstruct a nipple and areola. These reconstructions used excess skin on the Wise pattern vertical limbs to create a nipple, or on a "neopedicle" where both the areola and nipple were reconstructed and then mobilized superiorly into position as would be performed for a conventional mastopexy or reduction. Read More

World J Surg Oncol 2021 Apr 10;19(1):108. Epub 2021 Apr 10.

Department of Second Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, China.

Background: Mastoscopic surgery is proven to have lower incidence of postoperative complications and better postoperative recovery than traditional breast cancer surgery. This study aimed to examine the feasibility of mastoscopic modified radical mastectomy (MRM) with skin nipple-areola preservation under air cavity-free suspension hook and stage I silicone prosthesis implantation (SMALND) compared with routine MRM.

Methods: This was a retrospective study of patients who underwent MRM for breast cancer at the Shengjing Hospital Affiliated to China Medical University between January 1, 2019, and June 30, 2019. Read More

Plast Reconstr Surg 2021 May;147(5):1046-1057

From McGill University and the Division of Surgical Oncology, Jewish General Hospital.

Background: Prepectoral breast reconstruction is being increasingly popularized, largely because of technical advances. Patients with ptotic breasts and active cancer require mastectomies through a mastopexy excision pattern to achieve proper pocket control in a prepectoral single-stage operation. This article presents a single-surgeon experience with direct-to-implant, prepectoral reconstruction following skin-reducing mastectomies. Read More

Aesthetic Plast Surg 2021 Apr 2. Epub 2021 Apr 2.

Christine M Kleinert Institute of Hand and Microsurgery, 225 Abraham Flexner Way, Suite 750, Louisville, KY, 40202, USA.

Nipple areola reconstruction is an integral part of breast reconstruction and serves as the "cherry on top" of the reconstructed breast. These delicate tissues need protection and stabilization. There are many techniques to dress skin grafts and the NAC. Read More

Br J Surg 2021 Apr;108(3):296-301

Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France.

Background: Nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) is used increasingly when performing a prophylactic mastectomy. Few prospective studies have reported on complication rates. This complementary trial to the French prospective multicentre MAPAM trial aimed to evaluate the nipple-areola complex (NAC) necrosis rate in prophylactic NSM with IBR. Read More

ANZ J Surg 2021 06 16;91(6):1266-1270. Epub 2021 Mar 16.

Department of Plastic Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia.

Background: Coronary artery bypass grafting (CABG) is a common procedure performed commonly using left internal mammary artery (LIMA). We report a case of sternal wound dehiscence and breast necrosis following LIMA harvest in a 55-year-old obese lady with macromastia, diabetes mellitus, hypertension and end stage renal disease requiring dialysis. We also review the existing literature. Read More

Chin J Cancer Res 2021 Feb;33(1):33-41

Department of Breast Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.

Objective: Multi-center data on the current status and trends of breast reconstruction after mastectomy in China are lacking. Herein, we conducted a cross-sectional survey to investigate the current clinical practice pattern of postmastectomy breast reconstruction among Chinese female patients with breast cancer.

Methods: A standardized questionnaire used to collect information on breast reconstruction among females diagnosed with breast cancer was distributed by 31 members of the Chinese Society of Breast Surgery between January 1, 2018 and December 31, 2018. Read More

Aesthetic Plast Surg 2021 Mar 8. Epub 2021 Mar 8.

Department of Plastic and Reconstructive Surgery, Tokyo Medical University, 6-7-1 Nishishinjyuku Shinjyuku-ku, Tokyo, 160-0023, Japan.

Background: Nipple reconstruction using local skin flap leaves no morbidity in the healthy nipple. However, one disadvantage of this procedure is that the projection is not often maintained. There are few reports on the rate of long-term maintenance of nipple projection. Read More

Plast Reconstr Surg Glob Open 2021 Feb 16;9(2):e3397. Epub 2021 Feb 16.

Division of Breast and Endocrine Surgery, Department of Surgery, Borås Hospital, Gothenburg, Sweden.

Several oncoplastic techniques have been proposed for subareolar breast cancer, some of which may require contralateral operation for symmetry, or more than one operation for delayed reconstruction of the nipple-areola complex (NAC). We herein developed a simple and effective oncoplastic approach following central quadrantectomy, aiming to achieve the following: (1) preservation of breast shape and contour for patients who are not accepting of a notably smaller breast or bilateral operation; (2) single procedure with advantages of single anesthetic and the ability to reconstruct a breast that has not yet been affected by radiation; (3) no autologous grafts with disadvantage of an extra donor site; (4) creation of natural neo-NAC with only incision within the region of the areola complex; and (5) maintaining long-term nipple projection. In this technique, the medial and lateral peri-areolar flap was advanced and rotated to restore partial neo-NAC, and to fill the defect after central tumor and NAC resection. Read More

Data Brief 2021 Apr 5;35:106837. Epub 2021 Feb 5.

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.

Nipple-spring mastectomy (NSM) with immediate breast reconstruction is being increasingly used in the treatment of breast cancer [1]. However, there are limited available data on the prognostic implications of locoregional recurrence (LRR) following this surgical procedure. This article is a supplementary resource of the original research article by Wu ZY et al. Read More

Aesthet Surg J 2021 05;41(6):NP355-NP356

Gland Surg 2021 Jan;10(1):290-297

Department of Plastic and Reconstructive Surgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.

Background: Since the introduction of skin-sparing mastectomy (SSM), more breast surgeons have been preserving the areola and often nipple areolar complex (NAC) entirely. For better outcomes, more studies are necessary to analyze whether preserving the areola or NAC is unfavorable in breast reconstruction. The aim of this study was to assess the potential risk of areola or NAC preservation in direct-to-implant (DTI) breast reconstruction after SSM. Read More

Breast J 2021 Apr 23;27(4):363-368. Epub 2021 Feb 23.

Department of Gynaecology and Obstetrics, Faculty of Medicine University Hospital Cologne, University of Cologne, Cologne, Germany.

Subcutaneous nipple sparing mastectomies (NSM) are an important tool in modern oncoplastic surgery. Especially when an immediate implant-based reconstruction (IBR) is desired, clean margins are of the utmost importance. Central nipple biopsies during surgery serve two main purposes. Read More

Int J Surg Case Rep 2021 Mar 12;80:105297. Epub 2020 Nov 12.

Departments of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Sciences, Kawaramachi-Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan.

Introduction: Gigantomastia is a breast disorder characterized by exaggerated rapid growth of the breasts, generally bilaterally. In some severe cases, mastectomy is required to ensure safe delivery or control disease progression or recurrence. Subsequently, most patients want to undergo breast reconstruction, including the nipple-areola complex (NAC). Read More

Eur J Surg Oncol 2021 Jun 13;47(6):1309-1315. Epub 2021 Jan 13.

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. Electronic address:

Introduction: There are limited available data on the prognostic implications of locoregional recurrence (LRR) after nipple-sparing mastectomy (NSM) and immediate reconstruction. In this study, we investigated the patterns and prognosis associated with LRR following this treatment approach for breast cancer.

Methods: A total of 1696 patients with primary breast cancer who underwent NSM with immediate reconstruction from March 2003 to December 2016 were retrospectively analyzed. Read More

Ann Transl Med 2020 Dec;8(24):1665

Department of General Surgery, First Medical Center of the People's Liberation Army (PLA) General Hospital, Beijing, China.

Background: The past two decades have witnessed the increasing application of contralateral prophylactic mastectomy (CPM) for women with breast cancer in the western countries. Over 30% of young patients choose to underwent CPM up to 2015. However, the adoption rate of CPM has not shown a remarkably increasing in Asian countries. Read More

Ann Plast Surg 2021 05;86(5S Suppl 3):S395-S402

From the Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, CA.

Background: Nipple-sparing mastectomy (NSM) and autologous breast reconstruction are associated with higher patient satisfaction, quality of life, and aesthetic outcome. For patients with naturally ptotic breasts, this ideal reconstructive treatment of NSM and autologous breast reconstruction poses a challenge. We describe our experience in treating patients with ptotic natural breasts using a 2-staged approach: oncoplastic breast reduction in the first stage followed by nipple-sparing mastectomy and immediate autologous reconstruction in a second stage. Read More

Ann Med Surg (Lond) 2021 Jan 31;61:172-179. Epub 2020 Dec 31.

Department of Surgery, Paoli Calmettes Institute & CRCM & Aix Marseille Univ, 232 Bd Ste Marguerite, Marseille, France.

Introduction: Oncological safety, quality of life and cosmetic outcomes seems to be similar between breast conserving surgery (BCS) and mastectomy with immediate breast reconstruction (IBR). We report our experience of IBR for consecutive mastectomies realized in a recent period of four years in order to determined immediate surgical results according to type of mastectomy and type of reconstruction, as mains objectives.

Methods: All mastectomies with IBR during years 2016-2019 were included. Read More

Ann Surg Oncol 2021 Jan 9. Epub 2021 Jan 9.

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Background: A short tumor-to-nipple distance (TND) is reported as a strong predictor of nipple-areola complex (NAC) involvement. Eligibility for nipple-sparing mastectomy (NSM) remains controversial, especially regarding TND. In this study, we compared long-term oncologic outcomes after NSM between patients with a TND ≤ 1 cm and those with a TND > 1 cm. Read More

Aesthetic Plast Surg 2021 06 5;45(3):946-947. Epub 2021 Jan 5.

Division of Plastic Surgery, University of Toronto, Toronto, Canada.

Zhonghua Wai Ke Za Zhi 2021 Feb;59(2):121-126

Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

To examine the clinical application value of single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation in the treatment of early breast cancer. From February 2014 to July 2019, the clinic-pathological data of 34 early breast cancer patients received single-port inflatable endoscopic nipple sparing mastectomy with immediate reconstruction using prosthesis implantation at Department of General Surgery, Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed and followed up. All the patients were female, with an age of 46(11) years (()) (range: 26 to 64 years). Read More

Plast Reconstr Surg 2021 01;147(1):38-45

From the Department of Plastic and Reconstructive Surgery and the Division of Surgical Oncology and Breast Services, Cleveland Clinic; and Cereaga Plastic Surgery (private practice).

Background: Despite advances in skin envelope reduction techniques and experienced nipple-sparing mastectomy flap procedures, the rate of nipple malposition and secondary revision in these patients remains high and eligible candidates are limited. In this article, the authors present a novel technique combining skin reduction nipple-sparing mastectomy surgery with single-stage skin-only mastopexy and direct-to-implant reconstruction.

Methods: A retrospective review was performed at a single institution from 2015 to 2018. Read More

Ann Ist Super Sanita 2020 Oct-Dec;56(4):444-451

Centro Nazionale per le Tecnologie Innovative in Sanità Pubblica, Istituto Superiore di Sanità, Rome, Italy.

Background: Dermopigmentation, also known as medical tattooing, is a complementary technique in the reconstruction of the nipple-areola and an adjuvant procedure to improve colour mismatch. In 2009, tattooing of the nipple-areola complex (NAC) was introduced by Treviso Hospital through a project conducted in cooperation with the local section of the Italian Anti-Cancer League (LILT).

Methods: From 2010 to 2016, 169 patients treated for breast cancer underwent dermopigmentation treatments. Read More