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Updated: Feb 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
Use of acellular dermal matrix (ADM) in nipple reconstruction: the 'central-pillar technique'
Russell J Bramhall1, Paul T R Thiruchelvam1, Mae Concepcion2
1Department of Breast Surgery, Royal Marsden Hospital, London, UK.
Abstract:
Nipple reconstructions are prone to a variable and unpredictable degree of flattening, which in some cases lead to secondary reconstruction. The use of an acellular dermal matrix (ADM) augmentation may be appropriate in cases with very thin dermis that are particularly prone to flattening or in revision cases where the first procedure has already failed. The authors present a series of 13 nipple reconstructions in ten cases. Average projection at 12 months was 51% in primary cases and 46% in secondary revision cases. This represents a better than expected long term result in a difficult cohort of patients.

