The Hybrid Delay: A New Approach for Nipple-sparing Mastectomy in Macromastia.

Background: Patients with macromastia or breast ptosis can undergo a nipple-sparing mastectomy if their mastectomy flaps are delayed or if they are subjected to a breast reduction procedure and later undergo mastectomy.

Methods: In this report, we describe a new technique to combine these two approaches by initially performing a subtotal mastectomy through a Wise keyhole incision in combination with the retention of the nipple -areolar complex on an inferior pedicle flap. A tissue expander and an allograft are routinely placed during this first stage.