Nipple reconstruction using rib cartilage strut in microsurgical reconstructed breast

Nipple areolar reconstruction is the very last step of breast reconstruction. It is of outmost importance because it gives final appearance of breast, which is then better integreated by the patient in her body image. A lot of techniques are described to recreate nipple projection, from trompe l'œil tattoo to local flap, nipple sharing or autologous tissue graft. Common drawback of these techniques is nipple flattening with time, due to tissue atrophy. We present here a technique to use rib cartilage graft as structural framework for nipple reconstruction. Rib cartilage is stored in a pocked created in the groin during first step of breast microsurgical reconstruction. During nipple-areolar reconstruction, graft is cut at appropriate size and used inside a C-V flap to enhance nipple projection. Results show excellent symmetry and projection and is stable over time. Patients are very satisfied and can better integrate their new breast.