Evaluation of Complications Following Nipple Areola Sparing Mastectomy with Immediate Implant-Based Breast Reconstruction in Patients with Large Ptotic Breasts.

Background: Nipple sparing mastectomy has become a preferred method in breast cancer patients but safety of this procedure in large ptotic breasts needs to be documented to broaden its application. We aimed to assess complication rates of patients undergoing NSM and immediate implant-based reconstruction with skin reduction to determine the safety of reduction in this patient group. Methods: Patient with breast cancer and ptotic breasts whom received nipple sparing mastectomy and immediate implant-based breast reconstructions were analyzed, operated between April 2020 to last month of 2023 in Shiraz, Iran. Post-operative complications were recorded and analyzed. Results: The mean age and BMI of patients were 40.76 ± 5.0 and 23.72 ± 3.27 year, respectively. The median post-operative24 months (min 14, max 34). None of patients had disease recurrence. The most common complication was the flap full thickness necrosis, occurring in a total of 7 (20%) breasts. The incidence of full thickness necrosis was just seen in patients with ptosis grade III, and the most common site for the necrosis was the suture line [4/7 (12%)]. The other 3 patients had full thickness partial necrosis of NAC. We did not have any complete NAC necrosis. Conclusion: Nipple sparing mastectomy and immediate implant insertion in ptotic breasts, is a valuable method of reconstruction with acceptable rate of complications.