Arrow Flap and Rib Cartilage Graft for Nipple-Areola Complex Restoration
Restoration of the nipple-areola complex is a key component of breast reconstruction. The authors describe a reliable method of nipple-areola reconstruction using a combination of a dermal flap shaped like an arrow and a cartilage graft which provides a strong underlying scaffold support. The authors observed that techniques using isolated soft tissue dermal flaps can eventually fail due to secondary scar contracture with loss of neo-nipple projection. The cartilage graft is harvested at the initial breast flap transfer when exposing the internal mammary vessels. The arrow flap offers additional advantages against scar contracture due to its elegant design which allows the final incisions to resemble a W-plasty configuration on the new nipple vertical limb. The combination of arrow flap and rib graft leads to a reliable nipple reconstruction.
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