Nipple-Areolar Complex Reconstruction pp 427-432 | Cite as
One-Stage Breast Reconstruction Using the Inferior Dermal Flap, Implant, and Free Nipple Graft
Abstract
The inferior dermal flap with implant and free nipple graft is a valuable technical option available to women with ptotic breasts requiring immediate breast reconstruction. This single-stage procedure uses autologous tissue for an inferolateral dermal sling that is sutured to the pectoralis major muscle, supporting an implant and shaping the breast. Using the ipsilateral nipple as a free nipple graft facilitates immediate color matching with the contralateral nipple and conveys a far more elegant cosmetic reconstruction in comparison with that resulting from delayed nipple reconstruction or areolar tattooing. This one-stage operation avoids both a prolonged operation and also the costs and potential morbidity of prosthetic mesh use. This approach offers a safe, reliable, and cosmetically acceptable outcome for women with larger, ptotic breasts.
References
- 1.Breuing KH, Warren SM. Immediate bilateral breast reconstruction with implants and inferolateral AlloDerm slings. Ann Plast Surg. 2005;55(30):232–9.CrossRefPubMedGoogle Scholar
- 2.Saint-Cyr M, Dauwe P, Wong C, Thakar H, Nagarkar P, Rohrich RJ. Use of the serratus anterior fascia flap for expander coverage in breast reconstruction. Plast Reconstr Surg. 2010;125(4):1057–64.CrossRefPubMedGoogle Scholar
- 3.Bostwick J. Prophylactic (risk-reducing) mastectomy and reconstruction. In: Bostwick J, editor. Plastic and reconstructive breast surgery, vol. II. St Louis: Quality Medical Publishing; 1990. p. 1369–73.Google Scholar
- 4.Goyal A, Wu JM, Chandran VP, Reed MW. Outcome after autologous dermal sling-assisted immediate breast reconstruction. Br J Surg. 2011;98(9):1267–72.CrossRefPubMedGoogle Scholar
- 5.Echo A, Guerra G, Yuksel E. The dermal suspension sling: shaping the inferior pedicle during breast reconstruction. Aesthet Plast Surg. 2011;35(4):608–16.CrossRefGoogle Scholar
- 6.Spear SL, Sher SR, Al-Attar A. Focus on technique: supporting the soft-tissue envelope in breast reconstruction. Plast Reconstr Surg. 2012;130(5 Suppl 2):89S–94S.CrossRefPubMedGoogle Scholar
- 7.King ICC, Harvey J, Bhaskar P. One stage breast reconstruction using the inferior dermal flap, implant and free nipple graft. Aesthet Plast Surg. 2014;38(2):358–64.CrossRefGoogle Scholar
- 8.King ICC, Harvey J. One stage breast reconstruction using the inferior dermal flap, implant and free nipple graft. In: Shiffman MA, editor. Breast reconstruction: art, science and new clinical techniques. Berlin: Springer; 2015. p. 467–73.Google Scholar
- 9.Aydin H, Bilgin-Karabulut A, Tumerdem B. Free nipple reduction mammoplasty with a horizontal scar in high-risk patients. Aesthet Plast Surg. 2002;26(6):457–60.CrossRefGoogle Scholar
- 10.Munhoz AM, Montag E, Arrunda EG, Aldrighi C, Gemperli R, Aldrighi JM, Ferreira MC. Superior-medial dermoglandular pedicle reduction mammoplasty for immediate conservative breast surgery reconstruction: technical aspects and outcome. Ann Plast Surg. 2006;57(5):502–8.CrossRefPubMedGoogle Scholar
- 11.Ross GL. One stage breast reconstruction following prophylactic mastectomy for ptotic breasts: the inferior dermal flap and implant. J Plast Reconstr Aesthet Surg. 2012;65(9):1204–8.CrossRefPubMedGoogle Scholar
- 12.Rosato RE, Fink PJ, Horton CE, Payne RL Jr. Immediate postmastectomy reconstruction. J Surg Oncol. 1976;8(4):277–80.CrossRefPubMedGoogle Scholar
- 13.Ladizinsky DA, Sandholm PH, Jewett ST, Shahzad F, Andrews K. Breast reconstruction with the Bostwick autoderm technique. Plast Reconstr Surg. 2013;132(2):261–70.CrossRefPubMedGoogle Scholar
- 14.Spear SL, Willey SC, Feldman ED, Cocilovo C, Sidawy M, Al-Attar A, Hannan C, Seiboth L, Nahabedian MY. Nipple-sparing mastectomy for prophylactic and therapeutic indications. Plast Reconstr Surg. 2011;128(5):1005–14.CrossRefPubMedGoogle Scholar
- 15.Wise RJ. A preliminary report on a method of planning the mammoplasty. Plast Reconstr Surg. 1956;17:367–75.CrossRefPubMedGoogle Scholar
- 16.Regnault P. Breast ptosis: definition and treatment. Clin Plast Surg. 1976;34(2):193–203.Google Scholar
- 17.National Mastectomy and Breast Reconstruction Audit 2011. 22 Mar 2011. http://www.ic.nhs.uk/mbr. Accessed 31 Aug 2012.
- 18.Kijima Y, Yoshinaka H, Hirata M, Mizoguchi T, Ishigami S, Arima H, Nakajo A, Ueno S, Natsugoe S. Oncoplastic surgery combining partial mastectomy with breast reconstruction using a free nipple-areola graft for ductal carcinoma in situ in a ptotic breast: report of a case. Surg Today. 2011;41(3):390–5.CrossRefPubMedGoogle Scholar
- 19.Thorek M. Possibilities in the reconstruction of the human form 1922. Aesthet Plast Surg. 1989;13(1):55–8.CrossRefGoogle Scholar
- 20.Koger KE, Sunde D, Press BH, Hovey LM. Reduction mammoplasty for gigantomastia using inferiorly based pedicle and free nipple transplantation. Ann Plast Surg. 1994;33(5):561–4.CrossRefPubMedGoogle Scholar
- 21.Casas LA, Byun MY, Depoli PA, Gradinger GP. Maximizing breast projection after free-nipple-graft reduction mammoplasty. Plast Reconstr Surg. 2001;107:955–60.CrossRefPubMedGoogle Scholar
- 22.Bektas G, Cinpolat A, Bicici P, Unal K, Coskunfirat OK. A new application to free-nipple-graft reduction mammoplasty for breast and nipple projection. Eplasty. 2012;12:e37.PubMedPubMedCentralGoogle Scholar
- 23.Guven E, Aydin H, Basaran K, Aydin U, Kuvat SV. Reduction mammoplasty using bipedicled dermoglandular flaps and free-nipple transplantation. Aesthet Plast Surg. 2010;34(6):738–44.CrossRefGoogle Scholar
- 24.Lee TJ, Noh HJ, Kim EK, Eom JS. Reducing donor site morbidity when reconstructing the nipple using a composite nipple graft. Arch Plast Surg. 2012;39(4):384–9.CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Rusby JE, Smith BL, Gui GP. Nipple-sparing mastectomy. Br J Surg. 2010;97(3):305–16.CrossRefPubMedGoogle Scholar