Abstract
Background
Nipple reconstruction is the last step in breast reconstruction. An entirely satisfying breast reconstruction can be achieved only with a symmetrically placed and ideally shaped nipple-areola complex. Several techniques and modifications have been described for nipple-areola reconstruction but long-term projection loss is still a problem in nipple reconstruction.
Methods
Between January 2005 and October 2008, 13 female patients underwent 19 nipple reconstructions in our department. Among these patients, seven underwent breast reconstruction with a DIEP flap following unilateral mastectomy, and six were diagnosed with gigantomasty and underwent bilateral breast reduction with a modification of free nipple grafting. Our method for nipple reconstruction relies on a vertically oriented bipedicled flap with horizontally oriented extensions from the mid-portion.
Results
Nineteen nipple reconstructions in 13 patients were evaluated and the mean follow-up period was 15 months. We did not see any necrosis or any significant projection loss in our cases. Patients’ satisfaction was noted as high and the results were evaluated as pleasing.
Conclusion
We present a new technique that uses a bipedicled flap, oriented vertically. A rich blood supply to the flap may be the principal cause for long-lasting nipple projection.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Jabor MA, Shayani P, Collins DR Jr, Karas T, Cohen BE (2002) Nipple-areola reconstruction: satisfaction and clinical determinants. Plast Reconstr Surg 110:457–463; discussion 464–465
Tatlidede S, Yesilada AK, Egemen O, Bas L (2008) A new technique in nipple reconstruction: dome technique with double pedicle. Ann Plast Surg 60:141–143
Germano D, De Biasio F, Piedimonte A, Parodi PC (2006) Nipple reconstruction using the fleur-de-lis flap technique. Aesthetic Plast Surg 30:399–402
Mori H, Hata Y (2008) Modified C-V flap in nipple reconstruction. J Plast Reconstr Aesthet Surg 61(9):1109–1110
Dolmans GH, van de Kar AL, van Rappard JH, Hoogbergen MM (2008) Nipple reconstruction: the “Hammond” flap. Plast Reconstr Surg 121:353–354
Shestak KC, Gabriel A, Landecker A, Peters S, Shestak A, Kim J (2002) Assessment of long-term nipple projection: a comparison of three techniques. Plast Reconstr Surg 110:780–786
Adams WM (1949) Labial transplant for correction of loss of the nipple. Plast Reconstr Surg 4:295
Guerra AB, Khoobehi K, Metzinger SE, Allen RJ (2003) New technique for nipple-areola reconstruction: arrow flap and rib cartilage graft for long-lasting nipple projection. Ann Plast Surg 50:31–37
Hallock GG (1990) Polyurethane nipple prothesis. Ann Plast Surg 24:80–85
Farhadi J, Maksvytyte GK, Schaefer DJ, Pierer G, Scheufler O (2006) Reconstruction of the nipple-areola complex: an update. J Plast Reconstr Aesthet Surg 59:40–53
Losken A, Mackay GJ, Bostwick J (2002) Nipple reconstruction using the C-V flap technique: a long term evaluation. Plast Reconstr Surg 110:457
Lossing C, Brongo S, Holmström H (1998) Nipple reconstruction with a modified S-flap technique. Scand J Plast Reconstr Surg Hand Surg 32:275
Cronin ED, Humphreys DH, Ruiz-Razura A (1988) Nipple reconstruction: the S flap. Plast Reconstr Surg 81:783–787
Kroll SS, Hamilton S (1989) Nipple reconstruction with the double-opposing-tab flap. Plast Reconstr Surg 84:520–525
Kroll SS, Reece GP, Miller MJ, Evans GR, Robb GL, Baldwin BJ, Wang BG, Schusterman MA (1997) Comparison of nipple projection with the modified double-opposing tab and star flaps. Plast Reconstr Surg 99:1602–1605
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Turgut, G., Sacak, B., Görgülü, T. et al. Nipple Reconstruction with Bipedicled Dermal Flap: A New and Easy Technique. Aesth Plast Surg 33, 770–773 (2009). https://doi.org/10.1007/s00266-009-9368-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-009-9368-2