Nipple-Sparing Mastectomy with Immediate Breast Reconstruction: The Laterothoracic Approach without Robotic Assistance

Nipple-sparing mastectomy (NSM) has gained significant popularity in breast cancer surgery because of its superior aesthetic and psychological benefits compared with traditional mastectomy procedures. To enhance cosmetic outcomes, robot-assisted surgery has introduced laterothoracic incisions, which offer improved precision, flexibility, and the ability to conceal scars. Despite these advantages, widespread adoption of robot-assisted NSM has been limited. In this study, the authors present an innovative refinement of the NSM technique, using a laterothoracic upper lateral mammary fold incision without the need for robotic assistance. This minimally invasive approach conceals scars, ensures oncologic safety, and leverages standard surgical instruments, making it more accessible and cost-effective for a broader range of surgical practices.