I am BRCA 2 Positive with no known breast cancer diagnosis. I've researched NS PBM w/DIEP for about a year and come to the conclusion that coring the nipple appears to be the safest route. The last PS I met with said their group does not core the nipple, but if I need that done to feel comfortable, then she would go back in during a subsequent surgery after the blood supply from the initial DIEP is established and core the breast tissue from behind the nipple at that time. She said if you don't leave tissue behind, then it is basically a skin graft and leaves nothing for the blood supply to replenish itself with. I have been researching this surgery for 1.5 years now (spoken to 4 PS) and have never heard of this approach. So my questions are:
1.) Do you core the nipples in stage 1?
2.) How many stages does it take to complete a NS PBM with DIEP at your center?
3.) What are your thoughts on this PS approach to core the nipple in stage 2 once blood supply is reestablished.