Preservation of the nipple-areolar complex during subcutaneous mastectomy: A surgical and diagnostic method

Figure 1 Surgical steps. A: Skin incisions and breast tissue dissection; B: Mobilization of the flap with nipple-areolar complex; C: Breast tissue specimen; D: De-epithelization of the skin of the inferior mammary fold.

Figure 2 Auxiliary methods for tissue perfusion assessment. A: Intraoperative Doppler ultrasonography (USG); B: USG image; C: Intraoperative fluorescence angiography with indocyanine green; D: Fluorescence imaging of the lower de-epithelized flap.

Figure 3 Assessment of blood supply with indocyanine green. A: Subcutaneous tissue under nipple-areolar complex (NAC) 1 minute after indocyanine green (ICG) administration; B: NAC 1 minute after ICG administration; C: Subcutaneous tissue under NAC 3 minutes after ICG administration; D: NAC 3 minutes after ICG administration.

Figure 4 Preoperative and postoperative image. A: Preoperative; B: 3 months postoperative.