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Updated: Aug 6, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Characterization of Sex-Specific Immediate Breast Reconstruction Trends Following Mastectomy Between 2005 and 2023
Joseph D Quick1, Keyvon Rashidi2, Patrick Potoczak3
1Cleveland Clinic Lerner College of Medicine, 9501 Euclid Ave, Cleveland, OH, 44195, USA. quickj2@ccf.org.
Background:
Immediate breast reconstruction (IBR) following mastectomy is a standard of care in female patients; however, the role and characteristics of IBR in male patients remain poorly defined. Here, the authors aim to investigate IBR trends in both males and females.
Methods:
A retrospective analysis of male and female patients undergoing mastectomy from 2005 to 2023 was conducted using the National Surgical Quality Improvement Project (NSQIP) database (n = 450,925; male = 7,445, female=443,480). The most common methods of IBR (≥ 0.1% of patients) were identified using Current Procedural Terminology (CPT) codes. Demographics, comorbidities, outcomes, and rates of IBR were analyzed using independent t-tests and Chi-square tests. The association between year and rate of IBR by sex was investigated using a logistic regression model.
Results:
From 2005 to 2023, 21.0% of male (1,562) and 55.4% of female (245,750) patients underwent IBR following mastectomy (p < 0.0001). Among patients undergoing IBR, the most common male breast reconstruction procedures were nipple-areolar complex reconstruction (43.9%) and tissue expander placement (9.4%), whereas the most common female breast reconstruction procedures were tissue expander placement (42.7%) and implant placement (23.3%). The 30-day IBR surgical-site complication rate was low, with females suffering more morbidity than males (5.0% v. 3.2%, p < 0.001). There was an association between year and rate of IBR for both male (β = 0.2036, 95% CI 0.1871-0.2203, p < 0.0001) and female (β = 0.0428, 95% CI 0.0415-0.0440, p < 0.0001) patients.
Conclusions:
Compared to female patients, IBR remains low in male patients. However, the year-to-year growth in IBR is encouraging and may indicate increasing awareness and acceptance of reconstruction in male patients.
Level Of Evidence Iii:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .