{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:55:38Z","timestamp":1760057738582,"version":"build-2065373602"},"reference-count":73,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Macromastia is a well-known issue in breast reconstruction. Skin-reducing mastectomy (SRM) was introduced as a skin-sparing mastectomy that utilizes a skin reduction pattern similar to breast reduction or breast lift surgery, specifically to manage hypertrophic and pendulous breasts. Over time, numerous authors have contributed to refining the SRM technique, leading to the development of various technical variants. However, the diversity of approaches inspired by SRM has created confusion, and clear surgical indications are lacking. Methods: We propose a unifying concept called breast reshaping mastectomy (BRM), which encompasses all techniques based on SRM principles. The BRM aims not only to preserve and reduce the breast skin envelope but also to immediately reshape it for a more aesthetic outcome. This approach is applicable to all mastectomies where skin envelope preservation (with or without the nipple-areola complex) is oncologically safe, a modification of breast skin coverage is needed for better aesthetic results, and an implant-based reconstruction is planned. Results: To define the BRM concept, we reviewed the existing literature on SRM and its related techniques. Our analysis focused on four key elements: skin incision pattern, implant coverage strategy, nipple-areola complex (NAC) management, and the choice between two-stage and direct-to-implant reconstruction. Conclusions: By integrating these four components into a single surgical framework, BRM provides a structured approach to breast reconstruction that enhances both oncologic safety and aesthetic outcomes. Standardizing these techniques could help clarify surgical indications and improve reconstructive planning for patients undergoing skin-sparing mastectomy.<\/jats:p>","DOI":"10.3390\/jcm14041350","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T06:41:12Z","timestamp":1739860872000},"page":"1350","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["BRM: From Skin-Reducing Mastectomy to the New Concept of Breast Reshaping Mastectomy"],"prefix":"10.3390","volume":"14","author":[{"given":"Valerio","family":"Lorenzano","sequence":"first","affiliation":[{"name":"Scuola di Specializzazione in Chirurgia Plastica, Ricostruttiva ed Estetica, Universit\u00e0 Degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2134-5633","authenticated-orcid":false,"given":"Andrea Vittorio Emanuele","family":"Lisa","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, European Institute of Oncology, IRCCS, 20141 Milan, Italy"},{"name":"PhD Program in Applied Medical-Surgical Sciences, Department of Surgical Sciences, University of Rome \u201cTor Vergata\u201d, Viale Oxford 81, 00133 Rome, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5234-6044","authenticated-orcid":false,"given":"Valeriano","family":"Vinci","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy"},{"name":"Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, Rozzano, 20090 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3824-0830","authenticated-orcid":false,"given":"Benedetta","family":"Agnelli","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0635-7572","authenticated-orcid":false,"given":"Alessia","family":"Lozito","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Klinger","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, Rozzano, 20090 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Mela","sequence":"additional","affiliation":[{"name":"Scuola di Specializzazione in Chirurgia Plastica, Ricostruttiva ed Estetica, Universit\u00e0 Degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7439-4492","authenticated-orcid":false,"given":"Martina","family":"Caruso","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Klinger","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, Rozzano, 20090 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1097\/01.SLA.0000077922.38307.cd","article-title":"Skin-sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction is an oncologically safe procedure","volume":"238","author":"Gerber","year":"2003","journal-title":"Ann. Surg."},{"key":"ref_2","first-page":"1221","article-title":"Modified radical mastectomy","volume":"121","author":"Madden","year":"1965","journal-title":"Surg. Gynecol. Obstet."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1097\/00006534-199106000-00006","article-title":"Modified skin incisions for mastectomy: The need for plastic surgical input in preoperative planning","volume":"87","author":"Toth","year":"1991","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1002\/jso.2930080403","article-title":"Immediate postmastectomy reconstruction","volume":"8","author":"Rosato","year":"1976","journal-title":"J. Surg. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1097\/00000658-199705000-00013","article-title":"Skin-sparing mastectomy. Oncologic and reconstructive considerations","volume":"225","author":"Carlson","year":"1997","journal-title":"Ann. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/S0039-6109(16)45234-5","article-title":"Reconstruction after mastectomy","volume":"70","author":"Bostwick","year":"1990","journal-title":"Surg. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","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":"ref_8","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/00006534-200207000-00035","article-title":"Use of a skin-sparing reduction pattern to create a combination skin-muscle flap pocket in immediate breast reconstruction","volume":"110","author":"Hammond","year":"2002","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/00000658-191508000-00017","article-title":"Amputation of the Breast by a Transverse Incision","volume":"62","author":"Stewart","year":"1915","journal-title":"Ann. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/j.bjps.2007.06.032","article-title":"Skin-reducing mastectomy with breast reconstruction and sub-pectoral implants","volume":"61","author":"Nava","year":"2008","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"La Padula, S., Billon, R., Schonauer, F., D\u2019andrea, F., Noel, W., Belkac\u00e9mi, Y., Bosc, R., Hersant, B., and Meningaud, J.P. (2018). Skin-reducing oncoplasty: A new concept and classification in breast cancer surgery. Oncoplastie avec r\u00e9 duction de l\u2019enveloppe cutan\u00e9 e: Proposition d\u2019une nouvelle classification pour la chirurgie du cancer du sein. Annales de Chirurgie Plastique Esth\u00e9tique, Elsevier.","DOI":"10.1016\/j.anplas.2018.02.003"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1097\/01.PRS.0000164489.51776.BE","article-title":"The vertical pattern breast reconstruction for large or ptotic breasts","volume":"115","author":"Young","year":"2005","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Albright, W.B., and Hawkes, P.J. (2019). The Bell Pattern: A Novel Breast Incision Approach to Skin-Reducing Mastectomies. Aesthet. Surg. J. Open Forum., 2.","DOI":"10.1093\/asjof\/ojz031"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.ijsu.2010.08.004","article-title":"Experience with the Wise mammaplasty skin resection pattern in skin-sparing mastectomy and immediate breast reconstruction for large breast volumes","volume":"9","author":"Lie","year":"2011","journal-title":"Int. J. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1055\/s-2004-829042","article-title":"Trends in Autologous Breast Reconstruction","volume":"18","author":"Carlson","year":"2004","journal-title":"Semin. Plast. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1097\/00006534-200208000-00018","article-title":"Complete one-stage, immediate breast reconstruction with prosthetic material in patients with large or ptotic breasts","volume":"110","author":"Hudson","year":"2002","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1055\/s-0032-1315120","article-title":"Skin-reducing Mastectomy with Primary Implant Reconstruction","volume":"72","author":"Siggelkow","year":"2012","journal-title":"Geburtshilfe Frauenheilkd."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"187E","DOI":"10.1097\/PRS.0000000000007515","article-title":"Bostwick Autoderm and Implant Technique: Improved Outcomes for Obese Patients in Immediate Breast Reconstruction","volume":"147","author":"Danker","year":"2021","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1002\/bjs.7531","article-title":"Outcome after autologous dermal sling-assisted immediate breast reconstruction","volume":"98","author":"Goyal","year":"2011","journal-title":"Br. J. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e754","DOI":"10.1016\/j.bjps.2010.06.002","article-title":"Nipple-sparing mastectomy in women with large or ptotic breasts","volume":"63","author":"Rusby","year":"2010","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/9205805","article-title":"Single Stage Nipple-Sparing Mastectomy and Reduction Mastopexy in the Ptotic Breast","volume":"2018","author":"Pontell","year":"2018","journal-title":"Plast. Surg. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1007\/s00266-011-9745-5","article-title":"Use of deepithelialized flap in mammoplasties: Simple method with excellent results","volume":"35","author":"Mestak","year":"2011","journal-title":"Aesthetic. Plast. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/SAP.0b013e3182367bfd","article-title":"Immediate definitive prosthetic reconstruction in patients with ptotic breasts","volume":"70","author":"Gentileschi","year":"2013","journal-title":"Ann. Plast. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1097\/01.prs.0000232362.82402.e8","article-title":"A single surgeon\u2019s 12-year experience with tissue expander\/implant breast reconstruction: Part I. A prospective analysis of early complications","volume":"118","author":"Cordeiro","year":"2006","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1097\/PRS.0b013e3182a48b8a","article-title":"Breast reconstruction following nipple-sparing mastectomy: A systematic review of the literature with pooled analysis","volume":"132","author":"Endara","year":"2013","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1097\/01.prs.0000438056.67375.75","article-title":"Breast reconstruction following nipple-sparing mastectomy: Predictors of complications, reconstruction outcomes, and 5-year trends","volume":"133","author":"Colwell","year":"2014","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e1439","DOI":"10.1097\/GOX.0000000000001439","article-title":"Mastectomy Flap Thickness and Complications in Nipple-Sparing Mastectomy: Objective Evaluation using Magnetic Resonance Imaging","volume":"5","author":"Frey","year":"2017","journal-title":"Plast. Reconstr. Surg. Glob. Open."},{"key":"ref_28","first-page":"869","article-title":"Breast reconstruction after mastectomy","volume":"150","author":"Woods","year":"1980","journal-title":"Surg. Gynecol. Obstet."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.bjps.2013.02.007","article-title":"Simultaneous mastopexy in patients undergoing prophylactic nipple-sparing mastectomies and immediate reconstruction","volume":"66","author":"Woods","year":"2013","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1097\/SAP.0b013e3181a0cfee","article-title":"Wise-pattern breast reconstruction: Modification using AlloDerm and a vascularized dermal-subcutaneous pedicle","volume":"62","author":"Derderian","year":"2009","journal-title":"Ann. Plast. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3282","DOI":"10.1245\/s10434-012-2549-2","article-title":"Autologous inferior dermal sling (autoderm) with concomitant skin-envelope reduction mastectomy: An excellent surgical choice for women with macromastia and clinically significant ptosis","volume":"19","author":"Dietz","year":"2012","journal-title":"Ann. Surg. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1093\/asj\/sjw258","article-title":"Skin-Reducing Mastectomy in Immediate Reconstruction: How to Limit Complications and Failures","volume":"37","author":"Pechevy","year":"2017","journal-title":"Aesthet. Surg. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/PRS.0b013e3182958774","article-title":"Breast reconstruction with the Bostwick autoderm technique","volume":"132","author":"Ladizinsky","year":"2013","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1097\/PRS.0b013e3181e3b38a","article-title":"Dual-plane prosthetic reconstruction using the modified wise pattern mastectomy and fasciocutaneous flap in women with macromastia","volume":"126","author":"Losken","year":"2010","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/j.bjps.2012.03.040","article-title":"One stage breast reconstruction following prophylactic mastectomy for ptotic breasts: The inferior dermal flap and implant","volume":"65","author":"Ross","year":"2012","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_36","first-page":"12","article-title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia","volume":"34","author":"Pozzi","year":"2015","journal-title":"J. Exp. Clin. Cancer Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s00266-016-0732-8","article-title":"Becker Expander-Based Breast Reconstruction Following Wise Pattern Skin-Reducing Mastectomy: Complication Rates and Risk Factors","volume":"41","author":"Demiri","year":"2017","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s00266-009-9452-7","article-title":"Skin-reducing subcutaneous mastectomy using a dermal barrier flap and immediate breast reconstruction with an implant: A new surgical design for reconstruction of early-stage breast cancer","volume":"34","author":"Bayram","year":"2010","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1097\/SAP.0b013e31823b9a41","article-title":"Management of the ptotic or hypertrophic breast in immediate autologous breast reconstruction: A comparison between the wise and vertical reduction patterns for mastectomy","volume":"70","author":"Lin","year":"2013","journal-title":"Ann. Plast. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"S97","DOI":"10.1097\/SAP.0000000000000094","article-title":"Circumvertical mastectomy incision: Refinement in the surgical scar of implant-based breast reconstruction","volume":"72","author":"Griner","year":"2014","journal-title":"Ann. Plast. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.bjps.2011.09.023","article-title":"Nipple-areola complex sparing mastectomy with periareolar pexy for breast cancer patients with moderately ptotic breasts","volume":"65","author":"Rivolin","year":"2012","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_42","first-page":"8","article-title":"The Benefits and Pitfalls of Using an Autologous Dermal Flap in Immediate Implant-Based Reconstruction","volume":"13","author":"Garibotto","year":"2021","journal-title":"Cureus"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.bjps.2018.12.046","article-title":"Complications, patient-reported outcomes, and aesthetic results in immediate breast reconstruction with a dermal sling: A systematic review and meta-analysis","volume":"72","author":"Jepsen","year":"2019","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/SAP.0000000000001196","article-title":"A Simple Flap Design for the Salvage of Immediate Implant-Based Breast Reconstruction","volume":"80","author":"Yazar","year":"2018","journal-title":"Ann. Plast. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"296","DOI":"10.3109\/2000656X.2010.517681","article-title":"Skin-reducing mastectomy: New refinements","volume":"44","author":"Colizzi","year":"2010","journal-title":"J. Plast. Surg. Hand. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1016\/j.bjps.2018.05.027","article-title":"Immediate breast reconstruction with a wise pattern mastectomy and NAC-sparing McKissock vertical bipedicle dermal flap","volume":"71","author":"Lewin","year":"2018","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.ejso.2014.02.242","article-title":"\u201cImbricated dermal flap\u201d: A novel technique for autologous augmentation in immediate breast reconstruction after skin-sparing mastectomy","volume":"40","author":"Haydon","year":"2014","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3349","DOI":"10.1245\/s10434-013-3109-0","article-title":"Inferior dermal flap in immediate breast reconstruction","volume":"20","author":"Torstenson","year":"2013","journal-title":"Ann. Surg. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s00404-012-2636-4","article-title":"Bilateral prophylactic skin-reducing nipple-sparing mastectomy with immediate breast reconstruction using only a vascularized dermal-subcutaneous pedicle: Technique and possible advantages","volume":"287","author":"Vrekoussis","year":"2013","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1111\/j.1445-2197.2012.06313.x","article-title":"Experience in dermomyofascial pouch coverage of immediate implants following skin sparing reduction mastectomy","volume":"83","author":"Chang","year":"2013","journal-title":"ANZ J. Surg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/SAP.0000000000001614","article-title":"Skin-Reducing Mastectomy and Direct-to-Implant Breast Reconstruction With Submuscular-Dermal-Mesh Pocket","volume":"82","author":"Bonomi","year":"2019","journal-title":"Ann. Plast. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1097\/PRS.0b013e3182865a24","article-title":"A comparison of acellular dermal matrix to autologous dermal flaps in single-stage, implant-based immediate breast reconstruction: A cost-effectiveness analysis","volume":"131","author":"Krishnan","year":"2013","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_53","first-page":"e1338","article-title":"Acellular Dermal Matrix Versus Inferior Deepithelialized Flap Breast Reconstruction: Equivalent Outcomes, with Increased Cost","volume":"5","author":"Hon","year":"2017","journal-title":"Plast. Reconstr. Surg. Glob. Open."},{"key":"ref_54","doi-asserted-by":"crossref","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":"ref_55","doi-asserted-by":"crossref","first-page":"9301061","DOI":"10.1155\/2016\/9301061","article-title":"Modified Lower Pole Autologous Dermal Sling for Implant Reconstruction in Women Undergoing Immediate Breast Reconstruction after Mastectomy","volume":"2016","author":"Roy","year":"2016","journal-title":"Int. J. Breast Cancer"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13022-015-0012-3","article-title":"Early experience with implant based breast reconstruction for early breast cancer in ptotic breasts with non biological mesh and lower pole dermal sling","volume":"9","author":"Rathinaezhil","year":"2015","journal-title":"Ann. Surg. Innov. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.breast.2004.07.008","article-title":"Wise pattern mastectomy with immediate breast reconstruction","volume":"13","author":"Prathap","year":"2004","journal-title":"Breast"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/PRS.0b013e3182547d42","article-title":"Inverted-T skin-reducing mastectomy with immediate implant reconstruction using the submuscular-subfascial pocket","volume":"130","author":"Salgarello","year":"2012","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00006534-197707000-00001","article-title":"Mastopexy in conjunction with subcutaneous mastectomy","volume":"60","author":"Biggs","year":"1977","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1007\/s00266-017-0899-7","article-title":"Optimizing Patient Selection for Direct-to-Implant Immediate Breast Reconstruction Using Wise-Pattern Skin-Reducing Mastectomy in Large and Ptotic Breasts","volume":"41","author":"Inbal","year":"2017","journal-title":"Aesthetic. Plast. Surg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2480","DOI":"10.1245\/s10434-010-1058-4","article-title":"Skin-reducing mastectomy with immediate implant reconstruction as an indispensable tool in the provision of oncoplastic breast services","volume":"17","author":"Nair","year":"2010","journal-title":"Ann. Surg. Oncol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2276","DOI":"10.1111\/tbj.13985","article-title":"Evaluation of the medially pedicled skin-reducing nipple-sparing mastectomy as a standard mastectomy technique for large and ptotic breasts","volume":"26","year":"2020","journal-title":"Breast J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1111\/ans.12570","article-title":"Breast reconstruction using de-epithelialized dermal flap after vertical-pattern skin-sparing mastectomy in macromastia","volume":"85","author":"Peker","year":"2015","journal-title":"ANZ J. Surg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/j.bjps.2019.09.021","article-title":"The \u201cdermal cage\u201d: Inferiorly based dermal flap technique for breast reconstruction after mastectomy","volume":"73","author":"Vlajcic","year":"2020","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/j.bjps.2017.02.028","article-title":"A systematic review of complications associated with direct implants vs. tissue expanders following Wise pattern skin-sparing mastectomy","volume":"70","author":"Corban","year":"2017","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1007\/s00266-021-02246-y","article-title":"The First Use of Autologous Dermal Patch in DTI Pre-Pectoral Breast Reconstruction After Skin Reducing Mastectomy: A New Useful and Cheap Reconstruction Option","volume":"46","author":"Marongiu","year":"2022","journal-title":"Aesthetic. Plast. Surg."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.ejso.2014.01.003","article-title":"Skin reducing mastectomy and immediate reconstruction: The effect of radiotherapy on complications and patient reported outcomes","volume":"40","author":"Korwar","year":"2014","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1007\/s00266-014-0276-8","article-title":"One-stage breast reconstruction using the inferior dermal flap, implant, and free nipple graft","volume":"38","author":"King","year":"2014","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e426","DOI":"10.1097\/PRS.0000000000001574","article-title":"A Comparison of Elliptical Mastectomy to Inverted-T Pattern Mastectomy in Two-Stage Prosthetic Breast Reconstruction","volume":"136","author":"Kilgo","year":"2015","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"E2439","DOI":"10.1097\/GOX.0000000000002439","article-title":"Wise Pattern Direct Implant Breast Reconstruction: A Review and Improved Outcomes Using Dermal Matrix","volume":"7","author":"Friedman","year":"2019","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/tbj.12904","article-title":"Immediate nipple reconstruction in combination with implant reconstruction using dermal sling","volume":"23","author":"Filobbos","year":"2017","journal-title":"Breast J."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1097\/PRS.0000000000002227","article-title":"Skin-Reduction Breast Reconstructions with Prepectoral Implant","volume":"137","author":"Caputo","year":"2016","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1016\/j.bjps.2013.04.048","article-title":"Skin-reducing mastectomy and one-stage implant reconstruction with a myodermal flap: A safe and effective technique in risk-reducing and therapeutic mastectomy","volume":"66","author":"Irwin","year":"2013","journal-title":"J. Plast. Reconstr. Aesthet. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/4\/1350\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:36:51Z","timestamp":1760027811000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/4\/1350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,18]]},"references-count":73,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14041350"],"URL":"https:\/\/doi.org\/10.3390\/jcm14041350","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,2,18]]}}}