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Updated: Jun 5, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
The use of poly-lactic acid to improve projection of reconstructed nipple
L A Dessy1, A Troccola, R L M Ranno
1Department of Plastic and Reconstructive Surgery, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy. lucadessy@hotmail.it
Purpose:
Nipple-areola reconstruction represents an important step for final mammary reconstruction. Many techniques have been described. The drawback is the progressive nipple projection loss with time from 50% to over 70% of the initial projection. In this report, we evaluated the effect of injectable poly-lactic acid (PLLA) to improve projection of reconstructed nipples.
Results:
We selected 12 patients with a residual nipple projection between 0.1 and 2 mm. The patients were injected locally inside the nipple with 0.5 ml of PLLA (dilution 1:4) every 4 weeks for 4 times. At the study end, patients were satisfied with results. No adverse effects were observed. After one year, an increase of nipple projection ranging from 0.5 to 3.5 mm was obtained with an average increase of 2.3 mm (282%) and this variation was statistically significant (p < 0.0001).
Conclusion:
The use of injectable PLLA is a simple and effective procedure to improve projection of reconstructed nipple.
