A Video Guide to Reshaping the Breast Through Staged Mastopexy After Nipple-Sparing Mastectomy

Nipple-sparing mastectomy (NSM) has gained popularity because of its improved aesthetics and oncological outcomes. This study focuses on staged mastopexy as a technique for optimizing aesthetics in patients with a history of NSM and implant-based reconstruction. The authors aim to evaluate staged mastopexy as a technique to address complications such as implant and nipple-areolar complex malposition, rippling, and ptotic skin envelope, with a focus on patient selection, surgical technique, and patient-reported outcomes. The authors performed a retrospective analysis on a series of 5 patients who underwent NSM and immediate implant-based reconstruction with staged mastopexy by a single surgeon between 2020 and 2023. Descriptive analyses and t-tests were used. Significance was defined as P ≤ .05. The cohort consisted of 5 patients (10 breasts) with a median age of 43 ± 6.5 years, and average BMI was 22.9 ± 2.2 kg/m². The mean interval from mastectomy to mastopexy was 431.5 ± 232.1 days. Notably, no cases of partial or total nipple necrosis were observed. BREAST-Q surveys revealed significantly higher satisfaction scores for breasts (74 ± 19.9, P = .01) compared with normative values, with an 80% response rate. Staged mastopexy demonstrates a safe and reproducible technique for correcting nipple and implant malposition following NSM and implant-based reconstruction. Level of Evidence: 4 (Therapeutic).