Immediate nipple reconstruction with a local mastectomy flap following secondary DIEP flap breast reconstruction
10.3760/cma.j.issn.1009-4598.2018.02.003
- VernacularTitle: 腹壁下动脉穿支皮瓣联合胸壁皮瓣同期再造乳房和乳头
- Author:
Jinguang HE
1
;
Tao WANG
;
Hua XU
;
Yi ZHANG
;
Jiasheng DONG
Author Information
1. Department of Plastic and Reconstructive Surgery, Shanghai 9th People′s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
- Publication Type:Clinical Trail
- Keywords:
Breast reconstruction;
Nipples;
Deep inferior epigastric artery perforator;
Local skin flap;
Thorax
- From:
Chinese Journal of Plastic Surgery
2018;34(2):88-91
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effects of immediate nipple reconstruction with a local mastectomy flap in secondary breast reconstruction by deep inferior epigastric artery perforator (DIEP) flap.
Methods:A free bipedicle DIEP flap was raised and folded upward to form the breast. Meanwhile, a deepithelialized lower mastectomy flap with a distant skin paddle was elevated and pulled throughout the reconstructed breast. The skin paddle was carefully sutured to the position of future nipple. Three weeks later, the pedicle of mastectomy flap was divided, and the paddle was modeled to form the new nipple.
Results:From February 2011 to June 2016, 42 patients who had previously undergone unilateral modified mastectomies underwent the breast reconstructions and immediate nipple reconstructions. All flaps survived postoperatively. The average projection of the reconstructed nipple was measured as (16.3±2.4) mm immediately after the operation and gradually decreased to (8.4±1.3) mm by one year follow up. 35 patients ranked the aesthetic appearance of the reconstructed nipple and breast very good or good.
Conclusions:The immediate nipple reconstruction with a local mastectomy flap and breast reconstruction by DIEP flap could achieve a good breast shape and maintain a long term residual nipple projection, which results in considerable patient satisfaction.
