A New Convenient Incision Model of the Nipple-Sparing Mastectomy: Lateralized Parabolic Multiplanar Incision

• Published in: Aesthetic plastic surgery 2024-12, Vol.48 (23), p.4965-4972
• Main Authors: Sağır, Mehmet, Güven, Erdem, Saylik, Onur, Dülgeroğlu, Onur, Uras, Cihan
• Format: Article
• Language: English
• Subjects: Adult; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Breasts; Cicatrix - prevention & control; Cohort Studies; Esthetics; Female; Follow-Up Studies; Humans; Mammaplasty - adverse effects; Mammaplasty - methods; Mastectomy; Mastectomy, Subcutaneous - methods; Medicine; Medicine & Public Health; Middle Aged; Nipples - surgery; Original Articles; Otorhinolaryngology; Plastic Surgery; Retrospective Studies; Risk Assessment; Treatment Outcome; Wound Healing - physiology
• ISSN: 0364-216X; 1432-5241; 1432-5241
• DOI: 10.1007/s00266-024-04115-w

Background In this study, a lateralized parabolic multiplanar incision was defined. It was aimed to reduce necrosis in the nipple–areola complex (NAC) and, in the long run, to prevent the scar from pulling the areola laterally by maintaining healthy skin tissue between the scar and the areola and preserving the natural round appearance of the areola. Moreover, we purposed the scar not to be visible from the anterior view. Methods The study included 243 patients who underwent nipple-sparing mastectomy and immediate implant-based breast reconstruction. The incision was made 4–5 cm away from the lateral border of the NAC. The incision was completed after passing the anterior axillary line by drawing a parabolic curve in superolateral axis. Results The mean follow-up period was 24.6 months, and the mean age of the patients was 42.3 years. Full-thickness necrosis of the NAC occurred in 3.6% of breasts. In long-term follow-ups, the incision scar measured an average length of 8.6 cm. None of the patients had lateral displacement of the NAC. The NAC preserved its round appearance, except for 12 breasts that had full-thickness NAC necrosis. Ten breasts had an unnatural breast appearance. Conclusion The lateralized parabolic multiplanar incision is an ideal incision model for nipple-sparing mastectomy, as it allows for the exposure and reconstruction of all breast quadrants. We maintain areolar circulation; there are no visible scars when viewed anteriorly. Furthermore, it prevents lateral displacement of the NAC, ensuring that the natural round form of the NAC is not distorted. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .