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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Tuesday, November 8, 2022
According to a study in the journal Plastic and Reconstructive Surgery, many patients with breast cancer who have large, ptotic breasts have been essentially excluded from nipple-sparing mastectomies in the past. With a surgical technique called a batwing mastopexy, performed at the time of immediate breast reconstruction, more of these patients may benefit from nipple-sparing mastectomies in the future.
“Our findings show that a simultaneous batwing mastopexy can be safely performed at the time of immediate breast reconstruction, while providing comparable complication rates and improving the aesthetic outcome,” reported Hahns Y. Kim, MD, of Loma Linda University Medical Center, California, in a Wolters Kluwer press release.
Using retrospective chart review, Dr. Kim and colleagues identified patients who underwent immediate implant-based breast reconstruction from 2015 through 2020 at a single institution. The patients were divided into two cohorts: batwing mastopexy and standard reconstruction (no mastopexy). A total of 324 breast operations in 188 patients were included (80 concurrent batwing and 244 standard implant–based reconstructions). Patient characteristics were similar between the groups, except those in the batwing group had greater ptosis, and more patients in the standard group underwent adjuvant chemotherapy.
At an average of 16 months after mastectomy and immediate reconstruction, the two groups of women had similar outcomes. At least one complication occurred in 23.8% of operated breasts in the batwing mastopexy group and 27.5 % of the standard reconstruction group. Some minor complications, including hematoma and seroma, were less frequent with batwing mastopexy. In addition, the more serious complication of necrosis of the skin or nipple was less frequent with batwing mastopexy than with standard reconstruction (6.3% vs. 11.5%). Finally, the rate of revision surgery was lower with batwing mastopexy than without (23.7% vs. 30.3%).
Disclosure: The study authors reported no conflicts of interest.
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