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Nipple Reconstruction: A Novel Triple Flap Design.
Sofie H H Krogsgaard1,2, Lena F Carstensen3,4, Jørn B Thomsen5
1Department of Surgery, Section of Plastic Surgery, Hospital of Southwest Jutland, Esbjerg, Denmark.
Plastic and Reconstructive Surgery. Global Open
|July 24, 2019
Summary
A new triple flap technique for nipple reconstruction shows promising feasibility and low complication rates in breast reconstruction patients. Sustaining nipple projection long-term, however, remains a challenge for this novel approach.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Nipple-areola complex reconstruction is the final stage of breast reconstruction.
- Current local flap techniques for nipple reconstruction lack a universally superior design.
- This study introduces and evaluates a novel triple flap technique.
Purpose of the Study:
- To assess the feasibility of a new triple flap design for nipple reconstruction.
- To evaluate the complication rates associated with this technique.
- To measure nipple projection outcomes post-reconstruction.
Main Methods:
- A prospective study involving 26 nipple reconstructions in 22 women from November 2015 to November 2018.
- Utilized a template-guided triple flap design for nipple reconstruction.
- Postoperative follow-up assessed healing, complications (infection, dehiscence, necrosis), and nipple projection; areola tattooing was performed at 3 months.
Main Results:
- Successful reconstruction in all 26 cases, including 4 in irradiated tissue.
- A low complication rate was observed: one superficial infection, no flap necrosis or wound dehiscence.
- Prolonged healing occurred in 12% of non-irradiated cases; nipple projection decreased from 7.3mm initially to 1.6mm at 12 months.
Conclusions:
- The triple flap design is a feasible option for nipple reconstruction with a low complication rate.
- The technique demonstrates effectiveness in both irradiated and non-irradiated breast tissue.
- Maintaining nipple projection over the long term presents an ongoing challenge.
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