ArticleInternational journal of surgery (London, England)2025
Reverse‑sequence endoscopic nipple‑sparing mastectomy with direct‑to‑implant breast reconstruction and air inflation adjustment technique in patients with large or severely ptotic breast: a single-center prospective cohort study.
Article in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- [Aesthetic outcomes of synthetic mesh in single-axillary approach endoscopic implant-based breast reconstruction].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Article
- Advanced techniques for mastopexy in patients with ptotic breasts requiring nipple-sparing mastectomy: a narrative review.Gland surgery · 2026Review
- The current status and hot topics of endoscopic techniques in breast cancer surgery: a global bibliometric and visualization analysis (1999-2024).Gland surgery · 2026Article
- A retrospective comparison of clinical outcomes between endoscopic and open nipple-sparing mastectomy with immediate implant reconstruction versus breast-conserving surgery.American journal of translational research · 2026Article
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Authors and funding
9 authors.
Funding
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Abstract
backgroundThe applicability of reverse-sequence endoscopic nipple-sparing mastectomy (R-E-NSM) with direct-to-implant breast reconstruction (DIBR) is worth exploring in patients with large or severely ptotic breasts (LSPB) who were not recommended or even considered contraindicated in open NSM, conventional endoscopic NSM, and robotic NSM. The study aimed to compare the safety and aesthetic outcomes between patients with LSPB and non-LSPB (NLSPB) undergoing R-E-NSM with DIBR. MATERIALS AND
methodsThe single-center prospective cohort study enrolled 562 patients undergoing R-E-NSM and DIBR. Surgical safety, aesthetic outcomes, and oncologic safety were compared between patients with LSPB and NLSPB.
resultsAfter propensity score matching, 88 LSPB patients and 256 NLSPB patients were included (median [interquartile range] follow-up time: 21.0 [13.8, 32.4] vs. 23.0 [10.6, 32.2] months, P = 0.889). The mastectomy weight was significantly higher in the LSPB group (576.6 ± 144.8 g vs. 330.1 ± 105.7 g, P < 0.001). There were no significant differences in any complications (27.3% vs. 22.7%, P = 0.381), major complications (6.8% vs. 3.1%, P = 0.230), minor complications (20.5% vs. 21.1%, P = 0.889) and implant-related complications (21.6% vs. 24.6%, P = 0.566) between the LSPB and the NLSPB groups. In the LSPB group, the Ueda scores in patients with air inflation adjustment technique (AIAT) were better than those without AIAT, though no significant difference ( P = 0.110). Compared to the NLSPB group without AIAT, the LSPB group with AIAT had similar Ueda scores ( P = 0.870) and a significantly higher increase in BREAST-Q scores of breast satisfaction ( P = 0.004). Oncologic outcomes had no significant difference between the two groups (all P > 0.05).
conclusionR-E-NSM with DIBR and AIAT provides comparable surgical safety and aesthetic outcomes for patients with LSPB and NLSPB, offering a new option for LSPB patients.
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