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Updated: Jun 20, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Explantation with Lateral Pedicle Mastopexy
R Douglas Macmillan1, Kara Bell2, Emma Wilson1,3,4
1From Nottingham Breast Institute.
Background:
Although breast explantation combined with mastopexy is an increasingly common procedure, it does present certain technical difficulties. The authors present a technique of explantation mastopexy with the use of an extended lateral pedicle for autoaugmentation.
Methods:
A consecutive series of 40 cases was reviewed retrospectively, with a patient-reported outcome questionnaire and photography at 3 and 12 months.
Results:
The mean patient age was 57 years (range, 40 to 70 years), and the mean duration of implantation was 20.4 years (range, 7 to 42 years). Twelve women had undergone previous mastopexy (30%). Minor wound complications requiring simple dressings were seen in 7 patients (17.5%). Major infected wound problems occurred in 1 patient, who was a smoker and had other comorbidities. All except 1 patient reported being satisfied or very satisfied with the outcome, with a mean patient-reported satisfaction score of 4.9 of 5. When the photographs were independently assessed by a cosmetic practitioner, all patients were rated as average, good, or very good, with a mean score of 4.1 of 5.
Conclusions:
The procedure is associated with low risk of postoperative complications, good cosmetic outcomes, and a high degree of patient satisfaction. The authors believe this technique provides a logical, reproducible method for combined explantation and mastopexy.
Clinical Question/Level Of Evidence:
Therapeutic, IV.

