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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

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

  1. Remove Pectoralis Fascia and Breast Tissue
  2. 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

  1. Sarratus Plane Block
  2. PECs 2 Block

11. Post-op Remarks