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The oval technique for nipple-areolar complex reconstruction.

Amalia Vozza1, Fabio Larocca1, Giuseppe Ferraro1

  • 1Department of Plastic, Reconstructive and Aesthetic Surgery, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.

Archives of Plastic Surgery
|April 2, 2019
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Summary

This study presents an oval technique for nipple-areolar complex (NAC) reconstruction, combining local flaps and skin grafts. The method achieves excellent shape and projection with minimal complications, offering a versatile solution for breast reconstruction.

Keywords:
AreolaBreastMammaplastyNipple

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery

Background:

  • Nipple-areolar complex (NAC) reconstruction is a critical final step in breast reconstruction.
  • Achieving symmetry in position, size, shape, texture, pigmentation, and projection remains a challenge, with no universally adopted gold standard technique.
  • Existing literature details various NAC reconstruction methods, but none are definitively superior.

Purpose of the Study:

  • To introduce and evaluate a versatile, one-step technique for nipple-areolar complex (NAC) reconstruction.
  • To assess the efficacy of the oval technique in achieving optimal aesthetic and functional outcomes.
  • To compare the complication rates of this novel technique with existing methods.

Main Methods:

  • The technique involves a combination of modified local flaps and a full-thickness skin graft.
  • The procedure was performed on 40 patients (4 bilaterally), with a follow-up period of 30 months.
  • Subcutaneous equatorial sutures, skin grafting, and flap apex flattening were key components of the technique.

Main Results:

  • The technique enabled one-step reconstruction with excellent nipple projection and areola shape.
  • No cases of total nipple necrosis were reported; complications occurred in 10% of patients (infections, ischemia, hematoma).
  • Minimal reduction in areola diameter and negligible retraction in nipple diameter and projection were observed.

Conclusions:

  • The oval technique, a combination of C-V flap and cutaneous graft principles, significantly improves NAC reconstruction outcomes.
  • It offers excellent areola shape and nipple projection while substantially reducing nipple ischemia.
  • The method represents a significant advancement in reconstructive surgery for achieving optimal NAC aesthetics and function.