Reverse Expansion Following Nipple Sparing Mastectomy: A Natural, Safe and Effective Autologous Technique for Breast...

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncology

Background:

• Implant-based breast reconstruction is common post-mastectomy.
• Lipofilling offers a prosthesis-free alternative for breast reconstruction.
• Nipple-sparing mastectomy (NSM) preserves the nipple-areola complex.

Purpose of the Study:

• To evaluate the efficacy and safety of reverse expansion with lipofilling for breast reconstruction following NSM.
• To assess the use of a subpectoral skin expander in conjunction with fat grafting.

Main Methods:

• Retrospective review of 106 breast reconstruction procedures on 50 patients from January 2010 to August 2021.
• Fat tissue harvested via liposuction, centrifuged, and injected using specific cannulas.
• Breast expander deflated before fat injection to prepare the recipient site.

Main Results:

• Average fat harvested: 679.2 cc per session; average injected: 319.3 cc per breast.
• Mean of 2.4 sessions per breast; slightly more sessions in radiotreated patients.
• 99% complication-free rate (105/106 procedures) with a mean follow-up of 63.5 months.

Conclusions:

• Lipofilling using reverse expansion is a safe and effective technique for complete breast reconstruction post-NSM.
• The breast expander serves to optimize the recipient site for fat grafting.
• This method provides a like-with-like reconstruction and may be a primary choice for selected patients.