Robotic Nipple-Sparing Mastectomy and Breast Reconstruction with Profunda Artery Perforator Flaps

Area of Science:

• Oncology
• Plastic Surgery
• Surgical Innovation

Background:

• Single port robotic nipple sparing mastectomy (SPrNSM) is a novel, minimally invasive oncologic procedure.
• While implant-based reconstruction is common after SPrNSM, patient preference for autologous options exists.
• Autologous reconstruction offers an alternative for patients seeking tissue-based breast restoration.

Purpose of the Study:

• To evaluate the safety and efficacy of autologous tissue reconstruction using profunda artery perforator (PAP) flaps following SPrNSM.
• To assess the feasibility of performing PAP flap reconstruction using the same axillary incision as SPrNSM.
• To present outcomes for patients undergoing SPrNSM with immediate or delayed PAP flap reconstruction.

Main Methods:

• Retrospective review of six patients who underwent SPrNSM with PAP flap reconstruction between July 2022 and May 2023.
• SPrNSM was performed using a single axillary incision.
• PAP flaps were utilized for autologous breast reconstruction, with some patients requiring subsequent fat grafting.

Main Results:

• All six patients successfully underwent SPrNSM and PAP flap reconstruction.
• Reconstructions included three immediate and three delayed-immediate procedures.
• Three patients benefited from secondary fat grafting for improved aesthetic outcomes.

Conclusions:

• Autologous reconstruction with PAP flaps is a safe and effective option following SPrNSM.
• Utilizing the same axillary incision for both procedures minimizes surgical sites.
• PAP flap reconstruction provides a valuable alternative for patients desiring tissue-based breast restoration after robotic nipple sparing mastectomy.