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Updated: Jan 3, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Optimal intraoperative selection of the projection of silicone breast implant using simplified cotton sizers
Naohiro Ishii1, Yumiko Tani2, Tomoki Kiuchi1
1Department of Plastic and Reconstructive Surgery, International University of Health and Welfare Hospital, Nasushiobara City, Tochigi, Japan.
Background:
It is occasionally difficult to accurately measure the projection of the unaffected breast in unilateral breast reconstruction and decide the optimal projection of a silicone breast implant (SBI). SBI ready-made sizers are useful for selecting the optimal SBI; however, the cost of procuring multiple types of this ready-made sizers is high. Therefore, we aimed to develop a novel technique for selecting SBIs using simplified cotton sizers, intraoperatively.
Methods:
We applied the novel technique on 15 patients who underwent SBI-based breast reconstruction after simple mastectomy, among whom two or three SBI candidates had similar height and width but different projection. The breast reconstructed using a cotton SBI sizer was compared with the unaffected breast in the sitting position. We then selected the optimal SBI with a little higher projection than that of the unaffected breast. At the postoperative 1 year, we confirmed whether we could select better SBI among the prepared SBIs.
Results:
Creating and applying the cotton SBI sizer required approximately 10 min in all cases. Optimal SBI selection among the prepared SBIs was seen in 14 cases; capsule contracture occurred in 1 case.
Conclusions:
A simplified cotton SBI sizer is recommended because it is easy and inexpensive to develop and provides reliable assistance in identifying the optimal SBI projection.
