Superior Hemimastectomy with Inferior Pedicle Nipple-Bearing Flap: A
Five-Step Surgical Technique
by Morante, Lea; El Hajj, Houssein; Delecourt, Camille;
Sabiani, Laura; Bannier, Marie; Rua, Sandrine; Barrou, Julien; Lambaudie, Eric;
Houvenaeghel, Gilles; Cohen, Monique
Plastic and Reconstructive Surgery: January 2022
- Volume 149 - Issue 1 - p 13e-17e
Oncoplastic breast surgery is an evolving field combining
both breast aesthetic surgery and oncologic breast surgery. It aims to optimize
cosmetic outcomes without interfering with oncologic safety. The superior hemimastectomy
is a technique that can be considered for large upper-quadrant breast tumors or
multifocal and multicentric breast tumors localized in the upper quadrants. As
with mastectomy, axillary procedures can be performed through the same
incision. The nipple-areola complex can be preserved and reimplanted. Superior
hemimastectomy allows wide excision of the breast tissue, but its main
disadvantage is the increased risk of necrosis of the free grafted
nipple-areola complex. In this article, the authors present the surgical
technique of superior hemimastectomy with an inferior pedicle nipple-bearing
flap. This technique is presented as a simple five-step algorithm. A modified
superior hemimastectomy with nipple-areola complex preservation using an inferior
pedicle nipple-bearing flap is an alternative to the classic superior
hemimastectomy technique. This modified technique decreases the risk of
nipple-areola complex necrosis and preserves better nipple-areola complex
sensitivity.
