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Updated: Feb 4, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Immediate breast reconstruction with a wise pattern mastectomy and NAC-sparing McKissock vertical bipedicle dermal
Richard Lewin1, Christian Jepsen2, Håkan Hallberg1
1University of Gothenburg, The Sahlgrenska Academy. Department of Clinical Sciences, Gothenburg, Sweden; Department of Reconstructive and Plastic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Abstract:
Preservation of the nipple-areola complex (NAC) in immediate reconstruction of ptotic and large breasts is surgically challenging. This article presents a modification of the inferior dermal flap ("dermal sling") to a vertical bipedicle flap with NAC preservation. This flap is well described in breast reductions but has never been described in a mastectomy setting. The study reviews data for a case series of 17 breasts in 11 women who underwent breast reconstruction with the new technique. The complication rate was 12%, thus indicating that the vertical bipedicle NAC-sparing flap should be considered a feasible option for breast reconstruction in women with ptotic and/or large breasts.
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