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Duoderm®-Bra for Nipple-Sparing Mastectomy.

Deniz Dayicioglu1, Rose Trotta, Corin Agoris

  • 1From the *Division of Plastic Surgery, Department of Surgery, University of South Florida, Morsani College of Medicine; †University of South Florida, Morsani College of Medicine; and ‡Clinical and Translational Science Institute, University of South Florida, Morsani College of Medicine, Tampa, FL.

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Summary

The novel Duoderm®-bra technique in nipple-sparing mastectomy (NSM) improves nipple positioning and reduces complications. This method enhances aesthetic outcomes without increasing reconstruction time.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Oncology

Background:

  • Nipple-sparing mastectomy (NSM) with tissue expander reconstruction is a common breast reconstruction method.
  • Optimal nipple position and flap vascularity are crucial for aesthetic results in NSM.
  • High initial expander fill can cause nipple-areolar complex (NAC) ischemia, while low fill rates lead to poor aesthetic outcomes.

Purpose of the Study:

  • To evaluate the efficacy of the novel "Duoderm®-bra" technique in NSM.
  • To assess the impact of Duoderm®-bra on nipple positioning and ptosis.
  • To determine if Duoderm®-bra reduces complications compared to conventional methods.

Main Methods:

  • A retrospective chart review of 35 patients (65 breasts) undergoing NSM and tissue expander reconstruction.
  • Comparison between patients who received the "Duoderm®-bra" technique and those who did not.
  • Exclusion of patients who received acellular dermal matrix; recording of various clinical and aesthetic outcomes.

Main Results:

  • The Duoderm®-bra group showed significantly better nipple positioning (OR, 50.0; P < 0.0001).
  • Complication rates were higher in the non-Duoderm® group (OR, 4.5; P = 0.021).
  • No significant difference in the duration of tissue expansion between the groups was observed.

Conclusions:

  • The "Duoderm®-bra" technique is a novel approach for NSM without intraoperative tissue expansion.
  • This technique enhances nipple elevation, reduces ptosis, and decreases flap and NAC necrosis.
  • Duoderm®-bra improves aesthetic outcomes in NSM without prolonging the overall reconstruction period.