Deskinning in Inverted-T Mastopexy and Augmentation Mastopexy: A Retrospective Cohort Study
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ORIGINAL ARTICLE
BREAST SURGERY
Deskinning in Inverted-T Mastopexy and Augmentation Mastopexy: A Retrospective Cohort Study Andreas Larsen1 • Frederik L. Aaberg1 • Mathilde N. Hemmingsen1 • Tim K. Weltz1 • Mathias Ørholt1 • Peter Stemann Andersen1,2 • Faranak Sarmady1,2 Jens Jørgen Elberg2 • Peter Vester-Glowinski1 • Mikkel Herly1
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Received: 13 July 2020 / Accepted: 20 October 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Background Most surgeons choose to de-epithelialize when performing a mastopexy to minimize the risk of nipple-areola-complex (NAC) necrosis. Preservation of the dermis and thus the subdermal plexus is thought to be crucial for the survival of the NAC. However, this has never been scientifically proven. Deskinning involves resection of the epidermis and the dermis and is a timesaving alternative to de-epithelialization. In this study, we present data from mastopexy patients with or without implant surgery with total deskinning of the Wise pattern. Methods From September 2012 to March 2020, a single surgeon performed all inverted-T mastopexies using the deskinning technique. The patients were included retrospectively, and data were collected by reviewing the patients’ medical records with emphasis on NAC necrosis. Results The cohort consisted of 274 consecutive patients who underwent bilateral mastopexy. Of these, 134 patients underwent mastopexy as the only procedure and 140 patients underwent mastopexy in combination with implant surgery. The median follow-up was 29 months (IQR 13-40 months). No complete NAC-necrosis occurred. Unilateral, partial NAC necrosis occurred in three patients who underwent mastopexy in combination with implant surgery.
& Mikkel Herly [email protected] 1
Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, DK-2100 Copenhagen, Denmark
2
Amalieklinikken, Dronningens Tværgade 30, DK-1302 Copenhagen, Denmark
Conclusion The NAC necrosis rate following inverted-T mastopexy using the deskinning technique is comparable to the rate of NAC-necrosis reported in the literature following mastopexy using the de-epithelialization technique. Our findings support that the use of deskinning is a safe and time-efficient method for patients undergoing inverted-T mastopexy. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the table of Contents or the online Instructions to Authors www.springer.com/00266 Keywords Breast Mastopexy Deskinning Deepithelialization Necrosis NAC
Introduction Nipple-areola-complex (NAC) necrosis is a severe complication which affects approximately 0–5% of patients who undergo mastopexy [1]. NAC necrosis is caused by a compromised blood supply either due to arterial insufficiency or, more commonly, venous congestion of the NAC [2]. Previous reports suggest that
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