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Updated: Oct 7, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Single-Stage Mastopexy with Broad-Based Inferior Dermal Pedicle in Nipple-Sparing Mastectomy with Immediate
Ng Ding Yi1, Pek Chong Han1, Wu Yijun1
1Department of General Surgery, Plastic, Reconstructive & Aesthetic Surgery Service, Khoo Teck Puat Hospital, Yishun, Singapore.
Abstract:
This paper introduces a novel approach to breast reconstruction in ptotic breasts undergoing nipple-sparing mastectomy (NSM). The technique integrates single-stage mastopexy with a broad-based inferior dermal pedicle and immediate reconstruction, inspired by the Boston Modified Robertson technique. It addresses the concerns of nipple viability as well as postoperative aesthetics compared with conventional mastopexy techniques. The case report describes a 41-year-old woman diagnosed with left breast carcinoma who underwent a left NSM, followed by single-stage mastopexy with a broad-based inferior dermal pedicle and immediate pedicled transverse rectus abdominis myocutaneous flap reconstruction. The approach resulted in favorable outcomes, including preserved nipple viability, high aesthetic satisfaction, and minimal complications. Advantages over traditional methods include elimination of a vertical scar component, avoidance of free nipple grafting, and precise control of the distance between the nipple-areolar complex and inframammary fold, thereby enhancing breast shape.