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Purpose of Review <p>This review explores strategies to optimize outcomes in breast reconstruction following nipple-sparing mastectomy (NSM). It focuses on nerve preservation, implant-based reconstruction timing, closure techniques, and the use of supportive adjuncts to enhance functional and aesthetic results.</p> Recent Findings <p>Advances in nerve preservation techniques, such as intercostal nerve dissection and neurotization, have shown promise in improving nipple-areolar complex (NAC) sensation. Timing of implant-based reconstruction plays a key role in minimizing complications, particularly when adjuvant radiation therapy is needed. Robotic-assisted harvesting of musculocutaneous flaps is emerging to improve donor site outcomes. Negative pressure incisional wound therapy (NPWT) has been effective in reducing postoperative complications. Comparative studies of acellular dermal matrices (ADMs) versus synthetic meshes like GalaFLEX highlight differences in integration, capsular contracture rates, and cosmetic results.</p> Summary <p>Evolving surgical techniques and adjunctive therapies are enhancing both functional and cosmetic outcomes following NSM. Continued innovations in nerve preservation, reconstruction timing, and material selection are shaping the future of patient-centered breast reconstruction strategies.</p>

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Optimizing Breast Reconstruction: Nerve Preservation in Nipple-Sparing Mastectomy, Immediate and Delayed Implant-Based Reconstruction, Complex Closures, Acellular Dermal Matrix versus GalaFLEX, and Negative Pressure Wound Therapy

  • 期刊论文

  • 发表日期：

    2025年10月24日

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  • Deborah Dele-Oni,
  • Dylan Kaye,
  • Daniel Roh,
  • Michael R. Cassidy

摘要

Purpose of Review

This review explores strategies to optimize outcomes in breast reconstruction following nipple-sparing mastectomy (NSM). It focuses on nerve preservation, implant-based reconstruction timing, closure techniques, and the use of supportive adjuncts to enhance functional and aesthetic results.

Recent Findings

Advances in nerve preservation techniques, such as intercostal nerve dissection and neurotization, have shown promise in improving nipple-areolar complex (NAC) sensation. Timing of implant-based reconstruction plays a key role in minimizing complications, particularly when adjuvant radiation therapy is needed. Robotic-assisted harvesting of musculocutaneous flaps is emerging to improve donor site outcomes. Negative pressure incisional wound therapy (NPWT) has been effective in reducing postoperative complications. Comparative studies of acellular dermal matrices (ADMs) versus synthetic meshes like GalaFLEX highlight differences in integration, capsular contracture rates, and cosmetic results.

Summary

Evolving surgical techniques and adjunctive therapies are enhancing both functional and cosmetic outcomes following NSM. Continued innovations in nerve preservation, reconstruction timing, and material selection are shaping the future of patient-centered breast reconstruction strategies.