{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:29:15Z","timestamp":1791228555050,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T00:00:00Z","timestamp":1731024000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Mastectomy is performed prior to or concurrently with deep inferior epigastric perforator (DIEP) flap breast reconstruction. However, the complication rates of nipple\u2010sparing mastectomy (NSM) versus skin\u2010sparing mastectomy (SSM) with DIEP are not well\u2010characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included patients who underwent SSM or NSM with DIEP reconstruction between January 2019 and July 2022 at an academic institution. The primary outcome was 30\u2010day postoperative complication rate. Variables were compared using Student's <jats:italic>t<\/jats:italic>\u2010tests\/Wilcoxon rank\u2010sum and Chi\u2010square\/Fisher's exact tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 535 patients, 195 (36%) underwent NSM and 340 (64%) underwent SSM. The 30\u2010day postoperative complication rates did not differ between cohorts (16.4% in NSM vs. 16.8% in SSM, <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.9). The NSM cohort had a higher rate of any flap necrosis (9.2% vs. 3.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) compared to the SSM cohort, though rates of total DIEP flap loss rate did not differ (4.1% vs. 1.5% respectively). Site\u2010wide total DIEP flap loss was 2.4%. The NSM cohort had smaller preoperative sternal notch\u2010to\u2010nipple distances (25.0 vs. 26.5\u2009cm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and had lower rates of preoperative radiation therapy (28.2% vs. 42.9%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.002) compared to the SSM cohort. The cohorts did not differ in demographic or operative variables including reconstruction timing (delayed vs. immediate interval), readmission, and reoperation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Individuals who received an NSM prior to DIEP reconstruction had more flap complications compared to the SSM cohort. Both cohorts had comparable overall 30\u2010day postoperative complication rates and demographic variables, and rate of total DIEP flap loss was 2.4%. Patient preference can further guide surgical decision\u2010making.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.31256","type":"journal-article","created":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T03:28:28Z","timestamp":1731122908000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparing Safety Profiles of Skin\u2010Sparing and Nipple\u2010Sparing Mastectomy With Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Retrospective Analysis"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6508-987X","authenticated-orcid":false,"given":"Madeleine\u00a0M.","family":"Blazel","sequence":"first","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph\u00a0D.","family":"Quick","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4996-2141","authenticated-orcid":false,"given":"Rachel\u00a0E.","family":"Schafer","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Shukla","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0809-9143","authenticated-orcid":false,"given":"Shannon\u00a0S.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head &amp; Neck Surgery Stanford  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Bernard","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risal","family":"Djohan","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffi","family":"Gurunian","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic  Abu Dhabi UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah\u00a0N.","family":"Bishop","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic  Cleveland Ohio 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