Single-Stage Mastopexy with Broad-Based Inferior Dermal Pedicle in Nipple-Sparing Mastectomy with Immediate Reconstruction for Large, Ptotic Breasts.

This paper introduces a novel approach to breast reconstruction in ptotic breasts undergoing nipple-sparing mastectomy (NSM). The technique integrates single-stage mastopexy with a broad-based inferior dermal pedicle and immediate reconstruction, inspired by the Boston Modified Robertson technique. It addresses the concerns of nipple viability as well as postoperative aesthetics compared with conventional mastopexy techniques. The case report describes a 41-year-old woman diagnosed with left breast carcinoma who underwent a left NSM, followed by single-stage mastopexy with a broad-based inferior dermal pedicle and immediate pedicled transverse rectus abdominis myocutaneous flap reconstruction. The approach resulted in favorable outcomes, including preserved nipple viability, high aesthetic satisfaction, and minimal complications. Advantages over traditional methods include elimination of a vertical scar component, avoidance of free nipple grafting, and precise control of the distance between the nipple-areolar complex and inframammary fold, thereby enhancing breast shape.