A New Approach to Nipple-Sparing Mastectomy for Patients with Ptotic Breasts: A Single-Center, Retrospective Analysis of Feasibility and Treatment Outcomes
In brief
New breast technique had 10% implant loss in selected patients with ptosis
In this single-center review of 298 patients, the new technique had 10% implant loss, compared with 17.6% after skin-reducing mastectomy; recurrence and major complication rates did not differ significantly across the three approaches. Breast satisfaction scores were highest with the new technique, but the retrospective findings support it only as an option for selected patients, not as a proven improvement over other methods.
- Journal
- Journal of clinical medicine (Q1)
- Published
- 16 October 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 4, Very Low (CEBM 4)
- Authors
- Paweł Pyka, Andrzej Frejnagel, Dzmitry Karkotka, Olga Nowak
- PMID
- 42941543
- DOI
- 10.3390/jcm15208026
Why clinicians should know about it
- Picked for Plastic and Reconstructive Surgery (paper of the day, 1 November 2026): Comparative breast reconstruction techniques and Breast-Q outcomes
Abstract
Background/Objectives: Subcutaneous mastectomies with immediate implant-based reconstruction have become widely performed procedures worldwide. Patients with small, non-ptotic breasts are candidates for procedures that do not involve skin reduction (NSM), whereas those with macromastia and significant ptosis undergo procedures involving the excision of excess skin (SRM). However, there remains a small group of patients for whom neither of these two options is ideal. We have developed a technique for reducing the implant pocket without excising excess skin, specifically designed for this group of patients. Methods: We conducted a retrospective analysis of 298 patients (419 breasts) who underwent surgery at our center between 2016 and 2025, comparing the method we described (NSM-LR) with NSM and SRM. A statistical analysis was performed. We evaluated oncological outcomes, complication rates, and implant loss. Satisfaction with the reconstructed breast was assessed using the Breast-Q questionnaire. Results: All cases were R0 resection. Locoregional recurrence was as follows: NSM-3.1%, NSM-LR-9.1%, and SRM-5.4% (p = 0.2363). Major complications were as follows: NSM-25.4%, NSM-LR-21.2%, and SRM-33.8% (p = 0.0887). Implant loss was as follows: NSM-7.6%, NSM-LR-10%, and SRM-17.6% (p = 0.0155). Breast Q score was as follows: NSM-78, NSM-LR-82, and SRM-75. Conclusions: NSM-LR can be a reasonable option for selected patients requiring a subcutaneous mastectomy.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.