Risk Factors and Surgical Outcomes in Skin Sparing Mastectomy Followed by Immediate Bilateral Breast Reconstruction: A Case Report
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Abstract
This case report describes the experience of a 45‑year‑old patient with early‑stage bilateral invasive ductal carcinoma who underwent skin‑sparing mastectomy with immediate bilateral breast reconstruction using silicone implants. The patient had no significant comorbidities, and the tumors were located peripherally in both breasts without skin involvement or nipple‑areolar complex compromise. Detailed surgical planning was performed, preserving the skin flaps and placing subpectoral implants with intraoperative perfusion monitoring. The postoperative course was uneventful, with no necrosis, seroma, or infection, and the patient began early physical therapy for functional recovery. At six weeks, complete healing, adequate breast symmetry, and high aesthetic satisfaction were observed, and 12‑month follow‑up confirmed maintenance of results and absence of local recurrence. This case demonstrates that skin‑sparing mastectomy followed by immediate bilateral breast reconstruction is a safe and effective alternative that offers significant oncologic, aesthetic, and psychosocial benefits. Careful patient selection, meticulous surgical planning, and a multidisciplinary approach are key elements to optimize outcomes and minimize complications, significantly contributing to the patient’s quality of life and emotional well‑being.
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References
I. Slavin, S. A., Schnitt, S. J., Duda, R. B., Houlihan, M. J., Koufman, C. N., Morris, D. J., Troyan, S. L., & Goldwyn, R. M. (1998). Skin-sparing mastectomy and immediate reconstruction: Oncologic risks and aesthetic results in patients with early-stage breast cancer. Plastic and Reconstructive Surgery, 102(1), 49–62. https://doi.org/10.1097/00006534-199807000-00008
II. Franceschini, G., Scardina, L., Di Leone, A., Terribile, D. A., Sanchez, A. M., Magno, S., D’Archi, S., Franco, A., Mason, E. J., Carnassale, B., Murando, F., Orlandi, A., Barone Adesi, L., Visconti, G., Salgarello, M., & Masetti, R. (2021). Immediate prosthetic breast reconstruction after nipple-sparing mastectomy: Traditional subpectoral technique versus direct to implant prepectoral reconstruction without acellular dermal matrix. Journal of Personalized Medicine, 11(2), Article 153. https://doi.org/10.3390/jpm11020153
III. Toh, U., et al. (2020). Clinical outcomes of patients after nipple sparing mastectomy and immediate implant based breast reconstruction: A review of evidence. Journal of Personalized Medicine, 10(171)? (PMC).
IV. Schaverien, M. V. (2013). Immediate bilateral nipple-sparing mastectomy and implant-based breast reconstruction. Journal of Thoracic Disease, 5(3), 203–204.
V. Costeira, B., da Silva, F. B., Oom, R., Costa, C., Moniz, J. V., Abecasis, N., & Santos, C. R. (2025). Short term outcomes of post mastectomy immediate prepectoral implant based reconstruction following skin and nipple sparing mastectomies. Journal of Clinical Medicine, 14(20), 7181.
VI. Si, M., Jiao, Y., Xu, L., et al. (2025). Long-term outcomes of skin sparing mastectomy and nipple sparing mastectomy versus traditional mastectomy in breast cancer: A case control study. World Journal of Surgical Oncology, 23, 52. https://doi.org/10.1186/s12957-025-03695-4
VII. Singletary, S. E. (1996). Skin sparing mastectomy with immediate reconstruction: The M. D. Anderson Cancer Center experience. Annals of Surgical Oncology, 3(4), 411–416. https://doi.org/10.1007/bf02305673
VIII. Tan, B.-K., Chim, H., Ng, Z. Y., & Ong, K. W. (2014). Aesthetic design of skin sparing mastectomy incisions for immediate autologous tissue breast reconstruction in Asian women. Archives of Plastic Surgery, 41(4), 366–373.
IX. Xueyang, L., Yanli, W., et al. (2020). Skin and nipple areola sparing mastectomy with immediate breast reconstruction using TRAM flap and silicone implants. Oncology Research and Treatment, 43(7 8), 354–361.
X. Munhoz, A. M., et al. (2018). Prospective evaluation of late cosmetic results following implant breast reconstruction. Plastic and Reconstructive Surgery, 107(6), 1702–1709.
XI. Piper, M., Peled, A. W., Foster, R. D., et al. (2009). Total skin sparing mastectomy: A systematic review of oncologic outcomes and postoperative complications. Plastic and Reconstructive Surgery, 124(1), 1–10.
XII. van Bommel, A. C. M., de Ligt, K. M., Schreuder, K., et al. (2020). The added value of immediate breast reconstruction to health related quality of life of breast cancer patients. European Journal of Surgical Oncology, 46(9), 1848–1853.
XIII. Bailey, C. R., Ogbuagu, O. F., Baltodano, P. A., et al. (2017). Quality of life outcomes improve with nipple sparing mastectomy and breast reconstruction. Plastic and Reconstructive Surgery, 140(2), 219–226.
XIV. Luze, H., Nischwitz, S. P., Wurzer, P., Winter, R., Spendel, S., Kamolz, L.-P., & Bjelic Radisic, V. (2022). Assessment of mastectomy skin flaps for immediate reconstruction with implants via thermal imaging—a personalized approach? Journal of Personalized Medicine, 12(5), 740. https://doi.org/10.3390/jpm12050740
XV. Seth, I. (2024). Defining skin sparing mastectomy surgical techniques: Indications, outcomes, and timing of reconstruction. Annals of Breast Surgery, 8, 20.