Nipple malposition after bilateral nipple-sparing mastectomy with implant-based reconstruction: Objective...

Area of Science:

• Oncologic surgery
• Plastic and reconstructive surgery
• Medical imaging analysis

Background:

• Nipple-sparing mastectomy (NSM) is a recognized oncologic procedure.
• Objective assessment of aesthetic outcomes, particularly nipple-areolar complex (NAC) position, remains challenging after NSM.
• Standardized methods for evaluating symmetry post-bilateral NSM with reconstruction are needed.

Purpose of the Study:

• To objectively evaluate NAC malposition after bilateral NSM using BCCT.core software.
• To compare the software's objective analysis with subjective expert panel assessments.
• To determine the reliability and correlation of BCCT.core parameters in assessing NAC asymmetry.

Main Methods:

• Postoperative photographs of 43 patients undergoing bilateral NSM with implant reconstruction were analyzed.
• BCCT.core software was used to quantify NAC position and asymmetry.
• An expert panel of plastic surgery specialists evaluated nipple asymmetry and position.
• Interrater reliability and correlation between expert and software ratings were assessed using the intraclass correlation coefficient (ICC).

Main Results:

• The expert panel demonstrated excellent interrater reliability (ICC = 0.941).
• BCCT.core parameters, specifically the breast retraction assessment (BRA) score, showed a statistically significant positive correlation with expert panel ratings.
• The software's individual parameters correlated well with both mean expert ratings and its own overall assessment.

Conclusions:

• BCCT.core software provides a reliable and objective method for quantifying NAC malposition and asymmetry.
• These objective parameters can potentially guide treatment decisions in patients undergoing bilateral NSM with implant reconstruction.
• The study supports the use of BCCT.core for standardized aesthetic outcome evaluation in NSM procedures.