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. We present autologous tissue reconstruction with 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 our institution from July 2022 to May 2023 was performed. Six patients underwent SPrNSM with PAP flap breast reconstruction (three delayed immediate and three immediate reconstruction). Three patients underwent subsequent revision with fat grafting. Breast reconstruction following robotic nipple sparing mastectomy has typically been performed with implants. We present a series of patients treated with PAP flaps for autologous reconstruction utilizing the same remote axillary incision as used in SPrNSM.