{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T21:17:27Z","timestamp":1763155047555,"version":"3.45.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":307,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nipple-sparing mastectomy in medium-large, ptotic breasts presents challenges because of redundant skin and risks to the nipple\u2013areola complex (NAC). Advances in skin-reducing techniques and immediate prepectoral reconstruction aim to improve both oncological safety and aesthetic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The authors of this study present a novel surgical approach designed to enhance NAC vascularization by performing a nipple-sparing skin-reducing mastectomy exclusively through the lower lateral triangle of a Wise-pattern incision with immediate prepectoral polyurethane-coated breast implant (Microthane, POLYTECH, Dieburg, Germany) reconstruction. This approach seeks to minimize implant exposure risks by limiting the scar laterally, thus optimizing breast contour and patient satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective analysis of 10 patients undergoing monolateral procedures was conducted between April and August 2023. Inclusion criteria included Grade 2 ptosis with an expected nipple repositioning of \u22648\u2005cm. The technique preserved vascular connections through precise de-epithelialization and assessed intraoperative flap perfusion. Implant selection ensured symmetry. Postoperative outcomes were evaluated using the BREAST-Q questionnaire and routine follow-ups (18 months). Associations between BREAST-Q scores and patient characteristics were analyzed through Pearson correlation and analysis of variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean patient age was 52 years, BMI 24\u2005kg\/m2, and implant volume 328\u2005cc. Complication rates were low, with no cases of capsular contracture or implant displacement. BREAST-Q scores demonstrated high satisfaction, and a significant positive correlation was found between BMI and physical well-being (P = .03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This single-stage technique for immediate prepectoral breast reconstruction in ptotic breasts may be safe and provide good aesthetic and functional outcomes. Further studies with extended follow-up and greater numbers are warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 4 (Therapeutic)<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asjof\/ojaf133","type":"journal-article","created":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T12:44:53Z","timestamp":1762087493000},"source":"Crossref","is-referenced-by-count":0,"title":["Nipple-Sparing Skin-Reducing Mastectomy and Immediate Prepectoral Breast Reconstruction: A New Surgical Approach"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1755-4950","authenticated-orcid":false,"given":"Diletta Maria","family":"Pierazzi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulpjana","family":"Gjondedaj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"De Prizio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Neri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"2025111416132678300_ojaf133-B1","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1016\/j.bjps.2019.11.025","article-title":"Nipple-sparing skin-reducing mastectomy with reconstruction for large ptotic breasts","volume":"73","author":"Kontos","year":"2020","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2025111416132678300_ojaf133-B2","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1097\/01.prs.0000233024.08392.14","article-title":"Skin-reducing mastectomy","volume":"118","author":"Nava","year":"2006","journal-title":"Plast Reconstr Surg"},{"key":"2025111416132678300_ojaf133-B3","doi-asserted-by":"publisher","first-page":"e1077","DOI":"10.1097\/GOX.0000000000001077","article-title":"Reconstruction of the ptotic breast using Wise pattern skin deepithelialization","volume":"4","author":"Newman","year":"2016","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2025111416132678300_ojaf133-B4","doi-asserted-by":"publisher","first-page":"233e","DOI":"10.1097\/PRS.0000000000011028","article-title":"Immediate prepectoral implant-based breast reconstruction after J-pattern skin-reducing mastectomy","volume":"154","author":"Caputo","year":"2024","journal-title":"Plast Reconstr Surg"},{"key":"2025111416132678300_ojaf133-B5","doi-asserted-by":"publisher","first-page":"e358\u2013","DOI":"10.1016\/j.clbc.2018.12.015","article-title":"Breast reconstruction actualized in nipple-sparing mastectomy and direct-to-implant, prepectoral polyurethane positioning: early experience and preliminary results","volume":"19","author":"De Vita","year":"2019","journal-title":"Clin Breast Cancer"},{"key":"2025111416132678300_ojaf133-B6","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1111\/tbj.13113","article-title":"Direct-to-implant breast reconstruction: higher complication rate vs cosmetic benefits","volume":"24","author":"Gschwantler-Kaulich","year":"2018","journal-title":"Breast J"},{"key":"2025111416132678300_ojaf133-B7","doi-asserted-by":"publisher","first-page":"5659","DOI":"10.1007\/s00520-022-06919-5","article-title":"A systematic review and meta-analysis on the prepectoral single-stage breast reconstruction","volume":"30","author":"Liu","year":"2022","journal-title":"Support Care Cancer"},{"key":"2025111416132678300_ojaf133-B8","doi-asserted-by":"publisher","first-page":"213e","DOI":"10.1097\/PRS.0000000000011737","article-title":"Prepectoral breast reconstruction","volume":"155","author":"Seth","year":"2025","journal-title":"Plast Reconstr Surg"},{"key":"2025111416132678300_ojaf133-B9","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1097\/PRS.0b013e3181aee807","article-title":"Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q","volume":"124","author":"Pusic","year":"2009","journal-title":"Plast Reconstr Surg"},{"key":"2025111416132678300_ojaf133-B10","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/S0094-1298(20)30220-0","article-title":"Breast ptosis. 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