Reducing Donor Site Morbidity When Reconstructing the Nipple Using a Composite Nipple Graft.
10.5999/aps.2012.39.4.384
- Author:
Taik Jong LEE
1
;
Hyung Joo NOH
;
Eun Key KIM
;
Jin Sup EOM
Author Information
1. Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. tjlee@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Morbidity;
Nipples;
Reconstructive surgical procedures
- MeSH:
Breast;
Humans;
Intercostal Nerves;
Nipples;
Reconstructive Surgical Procedures;
Rectus Abdominis;
Retrospective Studies;
Sensation;
Tissue Donors;
Transplants
- From:Archives of Plastic Surgery
2012;39(4):384-389
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Numerous procedures are available for nipple reconstruction without a single gold standard. This study presents a method for reducing donor-site morbidity in nipple reconstruction using a composite nipple graft after transverse rectus abdominis musculocutaneous flap breast reconstruction. METHODS: Thirty-five patients who underwent nipple reconstruction using a composite nipple graft technique between July of 2001 and December of 2009 were enrolled in this study. To reduce the donor site morbidity, the superior or superior-medial half dome harvesting technique was applied preserving the lateral cutaneous branch of the fourth intercostal nerves. The patients were asked to complete a previously validated survey to rate the color and projection of both nipples, along with the sensation and contractility of the donor nipple; and whether, in retrospect, they would undergo the procedure again. To compare projection, we performed a retrospective chart review of all the identifiable patients who underwent nipple reconstruction using the modified top hat flap technique by the same surgeon and during the same period. RESULTS: Thirty-five patients were identified who underwent nipple reconstruction using a composite nipple graft. Of those, 29 patients (82.9%) responded to the survey. Overall, we received favorable responses to the donor site morbidity. Projection at postoperative 6 months and 1 year was compared with the immediate postoperative results, as well as with the results of nipples reconstructed using the modified top hat flap. CONCLUSIONS: The technique used to harvest donor tissue is important. Preserving innervation of the nipple while harvesting can reduce donor site morbidity.
