The inframammary approach to nipple-sparing mastectomy: The Georgetown University Hospital experience

Abstract

The evolution of nipple-sparing mastectomy (NSM) mirrors global trends in oncologic breast surgery with a strong emphasis on maximizing esthetic surgical results and oncologic outcomes. Preservation of the nipple areolar complex has raised the bar on prosthetic breast reconstruction for the patient and the surgeon. At Georgetown University Hospital, our experience with NSM continually evolves in order to improve intraoperative efficiency and long-term results. Notably, current practice habits include inframammary incision placement, routine use of permanent rather than frozen section for pathologic confirmation of tumor status, and direct visualization using illuminating breast retraction. Looking forward, matching patient anatomy, oncologic treatment goals, and personal preferences with reconstruction timing, device selection, and implant location should allow us to continue to improve surgical outcomes and patient satisfaction.