A Suitable Indication for Crescent Mastopexy: Achieving Optimal Nipple Position in Nipple-Sparing Mastectomies

Questions 1.What criteria determine a patient's candidacy for nipple-sparing mastectomy (NSM)? 2. What are the primary surgical options for breast reconstruction following NSM after oncologic treatment?3. What are the key considerations for performing crescent mastopexy, and what are the factors affecting its outcomes?4. What are the advantages of using crescent mastopexy in conjunction with NSM, and how can this combination enhance breast reconstruction outcomes? Case DescriptionA 26-year-old woman with a history of fibromyalgia underwent 6 cycles of neoadjuvant chemotherapy consisting of Taxotere, carboplatin, Herceptin, and PERJETA for estrogen/progesterone receptor-positive, HER2-positive invasive ductal carcinoma of the left breast.Preoperatively, it was noted that her left nipple-areolar complex (NAC) sat lower than the right, in addition to her inframammary fold sitting lower on her left side (Figure 1).She subsequently underwent bilateral nipple-sparing mastectomies (NSM) via an inframammary incision and a left axillary sentinel lymph node biopsy.Her mastectomies weighed 365 g on the left and 360 g on the right.During the same procedure, the plastic and reconstructive surgery (PRS) team performed bilateral breast reconstruction with subpectoral placement of 300-mL tissue expanders (TEs) (Figure 2).3/2/26, 11:25 AM A Suitable Indication for Crescent Mastopexy: Achieving Optimal Nipple Position in Nipple-Sparing Mastectomies https://www.hmpgloballearningnetwork.com/site/eplasty/case-qa/suitable-indication-crescent-mastopexy-achieving-optimal-nipple-position 1/6