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Updated: Aug 23, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
A comparative study of envelope mastectomy and immediate reconstruction (EMIR) with standard latissimus dorsi
A J Hayes1, J P Garner, W Nicholas
1Breast Unit, Department of General Surgery, Frimley Park Hospital, Portsmouth Road, Camberley, Surrey GU16 5UJ, UK. andrew.hayes@rmh.nthames.nhs.uk
Background:
Latissimus dorsi breast reconstruction has problems with scars at the donor site and on the reconstructed breast. We report the feasibility and aesthetic results of Envelope Mastectomy and Immediate Reconstruction (EMIR), which utilises a single lateral mammary fold incision.
Patients And Methods:
Between 2001 and 2002, 20 EMIRs were performed in 19 patients, one as a staged bilateral procedure. Twenty consecutive patients, matched for body habitus, who had undergone standard latissimus dorsi breast reconstruction by the same surgeon from 1996 to 2000 were used as controls. Patient satisfaction was assessed using a validated Body Image Scale. Standard post-operative photographs were scored by three independent observers.
Results:
Length of stay and complication rates were equivalent between both groups. Cosmetic self-assessment scores on the Body Image Scale and scores by the independent observers were satisfactory for both groups but no statistically significant difference was observed between groups.
Conclusions:
EMIR is a technically feasible and cosmetically acceptable method of immediate breast reconstruction.