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Updated: May 3, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Patient-centred decision making in breast reconstruction utilising the delayed-immediate algorithm.

Ryan P Ter Louw1, Ketan M Patel1, Michael Sosin2

  • 1Georgetown University Hospital, Department of Plastic Surgery, Washington, DC, USA.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|February 4, 2014
PubMed
Summary
This summary is machine-generated.

Some patients initially desiring autologous breast reconstruction opt for implants, prioritizing faster recovery and avoiding donor site issues. This approach offers high satisfaction and good aesthetic outcomes in select cases.

Keywords:
Cancer-related fatigueDelayed–immediate breast reconstructionPatient-centred outcomesPost-mastectomy radiation therapy

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Area of Science:

  • Plastic Surgery
  • Oncology
  • Reconstructive Surgery

Background:

  • Delayed-immediate reconstruction is valuable for patients needing post-mastectomy radiation therapy.
  • Autologous tissue repair offers cosmetic and long-term benefits, but some patients prefer implant-based reconstruction.
  • Patient motivations for switching from planned autologous to implant reconstruction are not well-documented.

Purpose of the Study:

  • To evaluate outcomes and patient satisfaction in patients who switched from planned delayed-immediate autologous breast reconstruction to implant-based reconstruction.
  • To identify key factors influencing this change in reconstructive strategy.

Main Methods:

  • Retrospective analysis of patients (2005-2011) who intended delayed-immediate autologous reconstruction but chose prosthetic reconstruction.
  • Inclusion criteria: patients meeting the above criteria.
  • Data collected: patient demographics, expansion details, time to reconstruction, complications, and patient-reported satisfaction.

Main Results:

  • Seven patients (10 breasts) were analyzed; mean age 50.2 years, BMI 32.1 kg/m².
  • Average expansion required 4.4 visits, mean volume 483 ml; mean time to reconstruction 14.6 months.
  • Complications included infection, dehiscence, capsular contracture; 100% achieved successful reconstruction with 100% patient satisfaction.

Conclusions:

  • Avoiding donor-site morbidity and seeking simpler recovery are primary drivers for choosing implants over autologous reconstruction.
  • Cancer-related fatigue and depression may influence patients towards less extensive surgery.
  • Offering definitive implant reconstruction to select patients is safe, yielding high satisfaction and aesthetic results.