Nipple-sparing mastectomy via an inframammary fold incision with implant-based reconstruction in patients with prior cosmetic breast surgery

Abstract

Background Nipple-sparing mastectomy through an inframammary fold incision (NSM-IMF) with implant-based reconstruction (IBR) is a cosmetically preferable approach to breast cancer treatment in appropriate candidates. However, patients who have undergone prior cosmetic breast surgery (CBS) may be at increased risk for postoperative complications secondary to existing surgical scars. Objective To assess whether prior CBS increases the risk of complications following NSM-IMF with IBR. Methods A retrospective chart review was conducted for 398 NSM-IMFs with IBR performed between July 2006 and December 2013. CBS cases were identified. Outcomes were reviewed. Results Of 398 NSM-IMF cases, 41 had prior CBS: 24 augmentations, 12 reductions, three mastopexies, and two augmentation mastopexies. NSM-IMF was performed an average of 8 years following CBS. CBS cases had lower BMIs (P =. 040), more breast tissue resected (P =. 021), wider breast bases (P =. 0002), more single-stage reconstructions (P