Related Experiment Video
Updated: May 16, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Rotation flap approach mastectomy
Nicola R Dean1, Jia Miin Yip, Stephen Birrell
1Flinders Medical Centre, Adelaide, South Australia, Australia. nicola.dean@health.sa.gov.au
Background:
The authors present a technique for mastectomy with greater versatility for reconstruction.
Methods:
The areola is marked and a vertical line is dropped medial to the breast axis, down towards the inframammary fold and laterally to the anterior axillary line. In large ptotic breasts, the markings are modified to reduce the skin envelope. The rotation flap is raised over the lateral half of the breast, and the remainder of the skin envelope is then separated from the breast tissue as per any other mastectomy. Skin closure is by rotation of the flap and incremental gathering of skin. An audit of 37 cases of rotation flap approach (RoFA) mastectomy has been performed, evaluating complications and post-reconstruction outcome using the BREAST Q.
Results:
RoFA has been found to offer good access for mastectomy and lymphadenectomy. A total of 7 of 37 patients had delay in healing, and 2 patients developed haematoma. Post-reconstruction outcome was scored as comparable with other published series.
Discussion:
The RoFA mastectomy has the potential to facilitate reconstructive results equivalent to skin-sparing mastectomy and immediate reconstruction.
