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Internal Mammary Perforator Preserving Nipple-Sparing Mastectomy (IMP-NSM) to Reduce Ischemic Complications

Mardi R. Karin, MD; Arash Momeni, MD; Candice N. Thompson, MD
Stanford University School of Medicine

Tags: General Surgery Oncologic Surgery Multidisciplinary Surgery

Main Text Procedure Outline Transcript

Table of Contents

1. Introduction
2. Review Breast MRI Blood Flow Patterns if Available
3. Mark Skin for IMP
4. Nipple-Sparing Mastectomy Skin Incision
5. Inject Tumescence
6. Raise Mastectomy Subcutaneous Flaps
7. Biopsy Under Nipple
8. Removing Pectoralis Fascia and Breast Tissue
9. Internal Mammary Perforator (IMP) Preservation
10. PECs and Serratus Blocks
11. Post-op Remarks

1. Introduction

2. Review Breast MRI Blood Flow Patterns if Available

3. Mark Skin for IMP

4. Nipple-Sparing Mastectomy Skin Incision

5. Inject Tumescence

6. Raise Mastectomy Subcutaneous Flaps

Remove Pectoralis Fascia and Breast Tissue
Check Thickness of Mastectomy Flap

7. Biopsy Under Nipple

8. Removing Pectoralis Fascia and Breast Tissue

9. Internal Mammary Perforator (IMP) Preservation

10. PECs and Serratus Blocks

Sarratus Plane Block
PECs 2 Block

11. Post-op Remarks

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