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Negative Pressure Wound Therapy for Improved Nipple Survival in Large Volume Reduction Mammaplasty

  • Innovative Techniques
  • Breast Surgery
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Large volume breast reductions are at increased risk of nipple ischemia and necrosis due to tenuous blood supply of long pedicles. We adapted incisional negative pressure wound therapy to augment nipple survival in such patients undergoing mammaplasty by inferior pedicle technique.

Methods

Patients with nipple-to-inframammary fold distance >14 cm were informed of increased risk of requiring free nipple graft. All patients underwent inferior pedicle technique with Wise pattern skin incision. Once incisions were closed and the nipple-areolar complex was inset, the complex was assessed for vascularity. In 12 cases there was evidence of compromised arterial inflow or venous outflow. For these patients, incisional negative pressure wound therapy was applied to the bilateral nipple-areolar complexes for 5-7 days.

Results

None of the 12 patients (24 breasts) in this series experienced nipple-areolar complex ischemia or necrosis. Only 2 patients experienced delayed wound healing which was successfully managed by local wound care.

Conclusions

This study demonstrates the utility of negative pressure wound therapy in nipple survival for at-risk patients. We believe it augments healing by allowing improved micro-circulation.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

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Authors and Affiliations

  1. Wayne State University School of Medicine, 540 E Canfield, Detroit, MI, 48201, USA

    Ricardo Engel

  2. Henry Ford Health System, Detroit, MI, USA

    Yitzchok Greenberg & Aamir Siddiqui

Authors
  1. Ricardo Engel
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  2. Yitzchok Greenberg
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  3. Aamir Siddiqui
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Correspondence to Ricardo Engel.

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The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all patients in this case series.

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Engel, R., Greenberg, Y. & Siddiqui, A. Negative Pressure Wound Therapy for Improved Nipple Survival in Large Volume Reduction Mammaplasty. Aesth Plast Surg 46, 108–112 (2022). https://doi.org/10.1007/s00266-021-02492-0

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  • DOI: https://doi.org/10.1007/s00266-021-02492-0

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