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An Innovative and Highly Efficient Single-Port Endoscopic Nipple-/Skin-Sparing Mastectomy and Dual-Plane Direct-to-Implant Breast Reconstruction: A Prospective Study from a Single Institution

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  • Breast Surgery
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Abstract

Background

The difficulty in creating and maintaining a stable workspace of the breast makes endoscopic nipple-/skin-spring mastectomy (E-N/SSM) develop slowly. This study aims to report the preliminary results of a novel endoscopic technique for N/SSM followed by dual-plane direct-to-implant (DP-DTI) breast reconstruction.

Methods

A prospectively maintained database was reviewed that included patients who underwent single-axillary-incision E-N/SSM and DP-DTI breast reconstruction from September 2020 to April 2021 at a single institution by three surgeons. The data were collected prospectively and analyzed to determine the efficacy, feasibility, safety, and esthetic results of the operation, as well as quality of life (QoL).

Results

During the study period, a total of 68 E-N/SSM and DP-DTI reconstruction procedures through a single axillary incision were performed in 63 female patients. Among all the procedures, the majority were performed for grade 1–3 ptotic breasts (n =46, 73.0%). During the median follow-up of 26.5 months, the major and minor surgical complication rates were 1.6% (1/63) and 9.5% (6/63), respectively. The cosmetic complication rate was 14.3%. One patient suffered local recurrence 4 months postoperation. The average scores in patient-reported outcomes at 2 years postoperation of satisfaction with breast (66.57), psychosocial well-being (75.93) and sexual well-being (56.29) were not significantly different compared with the baseline, except for physical well-being: chest (69.85).

Conclusions

The proposed procedure for E-N/SSM and DP-DTI breast reconstruction is feasible, time-saving and safe with good outcomes in terms of cosmetic results and QoL and expands the indications of DTI reconstruction to ptotic breasts, making it easier to popularize.

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.

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Acknowledgements

The authors would like to give special thanks to all the study patients who underwent surgery during the inclusion period.

Funding

This study was supported by grants from Key projects of Sichuan Provincial Health Commission (21PJ042); Incubation project of West China Hospital of Sichuan University (2022HXFH004); Natural Science Foundation of Sichuan Province (2022NSFSC0744); Key research and development projects of Sichuan Provincial Department of science and technology (2021YFS0104).

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Author notes

  1. Yu Feng, Faqing Liang and Nan Wen contributed equally to the study.

Authors and Affiliations

  1. Breast Disease Research Center, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, People’s Republic of China

    Yu Feng, Faqing Liang, Nan Wen, Huanzuo Yang, Jiao Zhou, Songbo Zhang, Xinran Liu, Mengxue Qiu, Yanyan Xie & Zhenggui Du

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  1. Yu Feng
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Contributions

Conceptualization and methodology, ZD; formal analysis, YF; writing—original draft preparation, YF, FL and NW; writing—review and editing, ZD, YF and FL. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Zhenggui Du.

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Conflicts of interest

The authors have not received financial support and do not have any conflicts of interest with respect to the research, authorship or publication of this article.

Informed Consent

Informed consent was obtained from all individual participants included in the study. All procedures performed in this study involving human participants were in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the ethics board of the West China Hospital of Sichuan University (No. 2022-723).

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Feng, Y., Liang, F., Wen, N. et al. An Innovative and Highly Efficient Single-Port Endoscopic Nipple-/Skin-Sparing Mastectomy and Dual-Plane Direct-to-Implant Breast Reconstruction: A Prospective Study from a Single Institution. Aesth Plast Surg 48, 1133–1141 (2024). https://doi.org/10.1007/s00266-023-03402-2

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