Robotic Nipple-Sparing Mastectomy and Breast Reconstruction with Profunda Artery Perforator Flaps

Abstract

SUMMARY: The single-port robotic nipple-sparing mastectomy (SPrNSM) was recently introduced. This approach is safe and has led to favorable outcomes in relation to cosmetic result, patient satisfaction, and breast sensation. The typical reconstruction with all robotic nipple-sparing mastectomies is implant based; however, this is not always what a patient desires. The authors present autologous tissue reconstruction with profunda artery perforator (PAP) flaps following SPrNSM using the same axillary incision. A retrospective review of all patients treated with a PAP flap for breast reconstruction and SPrNSM at the authors' institution from July of 2022 to May of 2023 was performed. Six patients underwent SPrNSM with PAP flap breast reconstruction (3 delayed-immediate and 3 immediate reconstructions). Three patients underwent subsequent revision with fat grafting. Breast reconstruction following robotic nipple-sparing mastectomy has typically been performed with implants. The authors present a series of patients treated with PAP flaps for autologous reconstruction using the same remote axillary incision as used in SPrNSM. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.