title: Surgical Delay Facilitates Pedicled Nipple-sparing Mastectomy and Reconstruction in the Ptotic Patient.
abstract: Significant ptosis is a relative contraindication for nipple-sparing mastectomy and reconstruction. Repositioning of the nipple on the reconstructed breast is best accomplished using a pedicled approach that is risky in the immediate setting. We utilized a surgical delay before reconstruction that allowed for repositioning of the nipple-areola complex on an inferior pedicle. This also allows for resizing of the nipple-areola complex, reliable complete coverage of the prosthesis with viable tissue, and creation of an ideal skin envelope in patients with skin excess. Here, we present the first description of a surgical delay to facilitate pedicled nipple-sparing mastectomy and reconstruction.
authors.affiliation: Georgia Breast Surgery, PC, Lawrenceville, Ga.; and Georgia Plastic Surgery and Reconstructive Care, Monroe, Ga.
authors.forename: Jean-Claude D
authors.initials: JC
authors.lastname: Schwartz
authors.affiliation: Georgia Breast Surgery, PC, Lawrenceville, Ga.; and Georgia Plastic Surgery and Reconstructive Care, Monroe, Ga.
authors.forename: Piotr P
authors.initials: PP
authors.lastname: Skowronksi