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Updated: May 7, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Breast surgery under local anesthesia: second-stage implant exchange, nipple flap reconstruction, and breast
Dimitri J Koumanis1, Alex Colque, Michael L Eisemann
1Capital Area Plastic Surgery of New York, 377 Church Street, Saratoga Springs, NY 12866, USA.
Abstract:
Breast reconstruction can be performed safely with local anesthesia. Utilization of the star flap method in conjunction with tattooing successfully provides optimal aesthetic results without the need for an additional donor site. When tissue expander to silicon implant exchange is part of the operative plan, use of triple antibiotic irrigation as well as the Keller Funnel is recommended. Breast augmentation and breast augmentation-mastopexy can also be performed with good results under local anesthetic in a private operating room setting. All other operative conditions, including sterility and sound operative surgical techniques, should be the mainstay of any practice.
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