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Nipple-Preserving Skin-Reducing Mastectomy in Ptotic Breasts: A Systematic Review and Meta-analysis
Osama Darras, Diwakar Phuyal1, Hannah Kornfeld2
1From the Cleveland Clinic Foundation, Cleveland, OH.
Annals of Plastic Surgery
|December 23, 2025
Summary
Skin-reducing mastectomy (SRM) with nipple preservation has a 23.97% complication rate, with nipple-areola necrosis being most common. Further research is needed to improve outcomes for patients undergoing this breast surgery.
Area of Science:
- Plastic Surgery
- Oncology
- Surgical Outcomes
Background:
- Skin-reducing mastectomy (SRM) allows simultaneous nipple-preserving mastopexy and mastectomy for ptotic breasts.
- Existing data on SRM complications are limited, primarily from single-center studies with small patient cohorts.
Purpose of the Study:
- To systematically review and analyze the complications associated with skin-reducing mastectomy (SRM).
Main Methods:
- A systematic review and meta-analysis of MEDLINE and Embase databases were conducted following PRISMA guidelines.
- Studies detailing nipple-preserving, skin-reducing mastectomy techniques and complications were included, excluding nipple grafting.
- Complications such as nipple-areola complex necrosis, infection, and wound dehiscence were assessed.
Main Results:
- Twenty-eight studies comprising 1201 breasts from 716 patients were analyzed.
- The overall complication rate for SRM was 23.97%, with nipple-areola complex necrosis being the most frequent (6.55%).
- The reoperation rate for any complication was 6.76%.
Conclusions:
- Nipple-areola necrosis is the most prevalent complication following skin-reducing mastectomy (SRM).
- Further investigation into factors influencing SRM outcomes is necessary to optimize patient results.
