ArticleCureus2026
Skin-Reducing Mastectomy and Submuscular Expander: A Preliminary Study on Patient-Reported Outcomes.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmediate implant-based reconstruction in large and ptotic breasts represents a significant surgical challenge. The skin-reducing mastectomy (SRM) pattern has been widely described to manage skin redundancy; however, immediate single-stage prepectoral reconstruction can be burdened by high complication rates in this specific population. While two-stage reconstruction with tissue expanders represents a classic alternative, patient-reported outcomes after SRM using this approach have not been reported in the literature. MATERIALS AND
methodsWe retrospectively reviewed a consecutive cohort of patients with large and ptotic breasts who underwent SRM and two-stage submuscular tissue expander reconstruction between 2022 and 2024. The primary objective was to evaluate postoperative complication rates. Secondary objectives included a preliminary evaluation of patient-reported outcomes six months after definitive implant placement using the validated BREAST-Q Reconstruction Module, alongside a narrative benchmarking of our results against historical literature series. Tissue expanders were placed in a dual-plane submuscular-subdermal pocket without the use of acellular dermal matrices.
resultsA total of 22 patients were included. Twenty patients (90.9%) successfully completed the two-stage reconstruction, while two (9.1%) experienced expander failure requiring explantation and autologous salvage, thereby excluding them from the BREAST-Q analysis. The total complication rate was 27.3% (6/22), and the surgical revision/implant failure rate was 9.1% (2/22). The BREAST-Q analysis highlighted high satisfaction scores regarding implants and postoperative breast appearance while revealing lower scores related to sexual well-being and cancer concerns. The literature review identified four relevant historical series characterized by small cohorts and the complete absence of patient-reported outcome data.
conclusionsThe use of a two-stage submuscular tissue expander after SRM in patients with ptotic, large breasts represents a feasible and reliable alternative for managing skin redundancy with an acceptable complication profile in a high-risk population. Given the retrospective and uncontrolled nature of this preliminary study, further prospective comparative trials are required to establish definitive comparative effectiveness.
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