Nipple-sparing mastectomy with immediate implant reconstruction is an increasingly popular technique for both treatment of breast cancer and risk-reducing surgery, with an evolving body of evidence confirming low complication rates and satisfactory patient outcomes. Immediate implant reconstruction usually requires use of one of many available meshes for complete implant coverage. The aim of this study was to assess outcomes after nipple-sparing mastectomy using synthetic absorbable TIGR mesh.
A retrospective review of a prospectively maintained database of 164 skin and nipple-sparing mastectomies with immediate implant reconstruction using TIGR mesh was performed. Data was retrieved and cross-checked with electronic patient records. Data was analysed with regard to patient demographics, indications for surgery, surgical procedure, complication rates and locoregional recurrence rates.
Of 164 implant reconstructions, forty-three were performed after nipple-sparing mastectomy. No differences in outcomes were seen between the two groups except for a higher incidence of skin or nipple necrosis in the nipple-sparing group (12% versus 2%). There was no nipple loss in this cohort. Infection rate in the nipple-sparing group was 9% versus 11% in the skin-sparing group, with implant loss rates of 9% and 6%, respectively. Mean follow-up was 23.6 months.
Our study has shown that immediate implant reconstruction after nipple-sparing mastectomy using TIGR mesh is safe and feasible, with low rates of early and medium-term complications.
Level of evidence: Level III, therapeutic study.