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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  >  > Accepted Manuscript
Chen Kuo,Lyu Pengwei.Application of pectoralis major fascia in robotic nipple-sparing mastectomy immediate breast reconstruction with gel implant[J].Chin J Burns Wounds,2026,42(1):1-8.DOI: 10.3760/cma.j.cn501225-20250807-00351.
Citation: Chen Kuo,Lyu Pengwei.Application of pectoralis major fascia in robotic nipple-sparing mastectomy immediate breast reconstruction with gel implant[J].Chin J Burns Wounds,2026,42(1):1-8.DOI: 10.3760/cma.j.cn501225-20250807-00351.
shu

Application of pectoralis major fascia in robotic nipple-sparing mastectomy immediate breast reconstruction with gel implant

doi: 10.3760/cma.j.cn501225-20250807-00351

  • Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

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    Abstract
  •   Objective  To preliminarily evaluate the feasibility, safety, and early aesthetic outcomes of using the pectoralis major fascia in robotic nipple-sparing mastectomy immediate breast reconstruction with gel implant (RNSMIBR).  Methods  This study was an retrospective cohort study. From November 2023 to April 2025, 34 female breast cancer patients who met the inclusion criteria and were treated at the First Affiliated Hospital of Zhengzhou University. Seventeen patients, aged 43±7 years, who underwent posterior subpectoral pocket expansion using a titanium mesh patch in RNSMIBR surgery were included into titanium mesh patch group, and 17 patients, age 46±7 years, who underwent posterior subpectoral pocket expansion using the pectoralis major fascia in RNSMIBR surgery were included into pectoralis major fascia group. Surgery-related complications during postoperative hospitalization and within 30 days after discharge were recorded and graded using the Clavien-Dindo classification. At the follow-up of approximately 3 months postoperatively, the BREAST-Q scale was used to score the patients' satisfaction with breast appearance, their psychosocial well-being, and satisfaction with medical care.  Results  During hospitalization and within 30 days after discharge, three patients in the titanium mesh patch group experienced grade I complications. In the pectoralis major fascia group, three patients experienced grade I complications and three patients experienced grade Ⅲb complications and the the grade Ⅲb complication in one patient was radiotherapy-related. No other complications occurred in the two groups. There was no statistically significant difference in the Clavien-Dindo classification of surgery-related complications between the two groups of patients (P>0.05). At the follow-up of approximately 3 months postoperatively, the BREAST-Q scale scores were 92±5 in the titanium mesh patch group of patients and 79±28 in the pectoralis major fascia group of patients, respectively, with no statistically significant difference between the two groups (t=1.85, P>0.05).  Conclusions  The pectoralis major fascia-assisted expansion may serve as an alternative option of expansion in RNSMIBR when titanium mesh patch is unavailable or cost-prohibitive. For patients requiring postoperative radiotherapy, titanium mesh patch or other materials that do not rely on vascular supply are still preferred to balance aesthetic outcomes and complication control.

     

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