Primary breast reconstruction with implant placement

Primary breast reconstruction with implant placement - subcutaneous mastectomy

Прим др Милош Почековац

What is a subcutaneous mastectomy?

Subcutaneous mastectomy is a surgical procedure during which the entire breast tissue is removed, but the skin, nipple and areola are preserved.

At the same time, breast reconstruction is performed with the installation of implants.

When was it first done?

In 1962, Freeman was the first to introduce the method of subcutaneous mastectomy with preservation of the skin and the nipple-areolar complex, in benign breast lesions, but not in the treatment of breast cancer or for prophylactic purposes.

In 1999, Hartman and his collaborators published in the New England Journal of Medicine at the Mayo Clinic, a study on prophylactic nipple-sparing mastectomy (NSM) in women at high risk for developing breast cancer. In this way, it reduced the risk of breast cancer by 81-94% in the high and moderate risk groups.

Is it done in people who have already been operated on, in order to reduce the risk on the opposite breast?

Studies (McDonald) have shown that the incidence of cancer of the opposite breast is significantly reduced after prophylactic mastectomy in women with a positive family history.

Can people with large and sagging breasts be candidates for this surgery?

Studies have shown that an inframammary incision (below the breast) or an inferolateral (lower outer) incision leads to the least complications such as lateralization (displacement) of the nipple or necrosis of the skin and nipple.