This video features surgical photos from a recent case of nipple-sparing mastectomy followed by pre-pectoral breast reconstruction at MUSC Hollings Cancer Center. Surgical oncologist Andrea M. Abbott, M.D., narrates the photos from the nipple-sparing mastectomy, and plastic surgeon Jason P. Ulm, M.D., walks us through the prepectoral breast reconstruction.
Nipple-sparing mastectomy, in which breast glandular tissue is extracted through a small incision while the skin and nipple of the breast remain intact, minimizes scarring and sets the stage for a more natural, cosmetically pleasing breast reconstruction. Unlike traditional implants, which are placed under the chest muscle and require cutting of the pectoralis major, prepectoral implants are placed above the muscle just under the skin, considerably reducing patient pain and morbidity. The appearance of “rippling” under the skin that was an early drawback of the technique has been overcome by the availability of lipofilling, in which fatty tissue harvested from the abdomen is layered over the prepectoral implant, improving its appearance. Patients should be aware, however, that the implants do not feel like natural breasts.