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Keyhole Flap Nipple Reconstruction.

Joseph I Chen1, Camille G Cash1, Al-Haj Iman1

  • 1Division of Plastic Surgery, Houston Methodist Hospital, Houston, Tex.; and Division of Plastic Surgery, St. Joseph Hospital, Houston, Tex.

Plastic and Reconstructive Surgery. Global Open
|September 1, 2016
PubMed
Summary

The keyhole flap technique offers a reliable method for nipple-areola reconstruction, achieving good symmetry and projection. This approach reconstructs the nipple mound effectively, enhancing the final breast reconstruction outcome.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery

Background:

  • Nipple-areola reconstruction is a crucial final step in breast reconstruction.
  • It significantly impacts the aesthetic outcome and patient satisfaction.

Purpose of the Study:

  • To evaluate the efficacy of the keyhole flap technique for nipple-areola reconstruction.
  • To assess symmetry, projection, and patient follow-up outcomes.

Main Methods:

  • Performed 133 nipple-areola reconstructions over 4 years.
  • Utilized the keyhole dermoadipose flap technique in 76 cases.
  • Flap tissue sources included transverse rectus abdominis myocutaneous, latissimus dorsi, and mastectomy skin flaps.

Main Results:

  • The keyhole flap technique demonstrated reliability and simplicity in construction.
  • Achieved good nipple projection and symmetry, matching the contralateral side when present.
  • Average follow-up was 17 months, with areola tattooing performed 3 months post-nipple reconstruction.

Conclusions:

  • The keyhole flap is a simple, reliable technique for nipple-areola reconstruction.
  • It provides satisfactory symmetry and projection, avoiding new scars.
  • This method is integral to transforming a breast mound into a complete breast form.