Nipple Reconstruction with Rolled Dermal Graft Support.
10.5999/aps.2014.41.2.158
- Author:
Hui Ling CHIA
1
;
Manzhi WONG
;
Bien Keem TAN
Author Information
1. Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital, Singapore.
- Publication Type:Original Article
- Keywords:
Mammaplasty;
Nipples;
Dermis;
Transplants
- MeSH:
Bandages;
Breast;
Cicatrix;
Dermis;
Female;
Humans;
Mammaplasty;
Nipples*;
Rectus Abdominis;
Superficial Back Muscles;
Tissue Donors;
Transplants*
- From:Archives of Plastic Surgery
2014;41(2):158-162
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Loss of nipple projection is a common problem following nipple reconstruction. The aim of this study was to demonstrate that the use of a tightly rolled dermal graft is effective in the long-term maintenance of nipple projection. METHODS: Nipple reconstruction was performed using the C-V flap technique. A dermal graft was harvested from the dog-ear portion of previous scars. The graft was rolled tightly into a compact cylinder and used to augment the nipple reconstruction. Postoperatively, stacked Allevyn dressing was used for protecting the nipple from compression for a minimum of two months. Nipple projection was measured at the time of surgery and at 12 months postoperatively. RESULTS: Forty nipple reconstructions were performed using this technique. There were 19 transverse rectus abdominis musculocutaneous (TRAM) flaps, 10 latissimus dorsi (LD) flaps, and 11 tissue-expanded breast mounds. At one year, the mean projection was 0.80 cm (range, 0.62-1.22 cm). The twelve-month average maintenance of nipple projection was 70.2% for the TRAM flap group, 76.3% for the LD flap group, and 61.8% for the tissue-expanded group. In two patients with previous irradiation of the reconstructed breasts, relatively poor maintenance of nipple projection was noted (45.7%). No complications were noted, and all of the donor sites healed well primarily. CONCLUSIONS: Our results demonstrated that the use of a C-V flap with a tightly rolled dermal graft for nipple reconstruction improves the long-term maintenance of nipple projection. Its advantages include reproducibility, technical simplicity, cost-effectiveness, and minimal donor site morbidity.
