[Prophylactic mastectomy with immediate breast reconstruction: Management of ptotic and hypertrophic breasts].

Authors

C Philandrianos, D Casanova

Published in

Annales de chirurgie plastique et esthetique. Volume 71. Issue 6. Pages 601-613.

Abstract

Bilateral prophylactic mastectomy with immediate breast reconstruction is an effective risk-reducing strategy for breast cancer in high-risk patients. However, its implementation in patients with breast hypertrophy and/or ptosis presents specific challenges, particularly related to skin envelope management. The presence of excess skin, combined with vascular changes induced by mastectomy, increases the risk of complications, especially cutaneous or nipple-areolar complex necrosis due to ischemia. Furthermore, achieving a satisfactory aesthetic outcome requires adaptation of reduction and reconstruction techniques. Management therefore relies on a balance between complete glandular excision and preservation of skin vascularity. It involves multiple strategic decisions, including skin envelope reduction, preservation or removal of the nipple-areolar complex, one-stage versus two-stage procedures, as well as the type and modalities of reconstruction. The aim of this article is to propose a structured, decision-making approach to the management of these patients, detailing fundamental principles and the various possible therapeutic strategies.

PMID:
43014843
Bibliographic data and abstract were imported from PubMed on 12 Nov 2026.

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