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Related Experiment Video

Updated: Oct 12, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Secondary nipple reconstruction using two surgical techniques.

Jae-Ho Chung1, Da-Som Kim1, Hyun-Dong Yeo1

  • 1Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Korea.

Archives of Plastic Surgery
|November 25, 2021
PubMed
Summary

Secondary nipple reconstruction can restore projection after initial flattening. Star flaps and purse-string sutures, chosen based on scarring and height, offer effective solutions for nipple projection.

Keywords:
NipplesReconstructive surgical proceduresSurgical flaps

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Oncology

Background:

  • Nipple projection often diminishes after primary reconstruction.
  • Effective secondary nipple reconstruction methods are not well-established.
  • This study reviews institutional experience with secondary nipple reconstruction.

Purpose of the Study:

  • To evaluate the effectiveness of secondary nipple reconstruction techniques.
  • To compare outcomes of different surgical methods for nipple revision.

Main Methods:

  • Retrospective review of secondary nipple reconstructions (March 2012 - January 2019).
  • Intervention performed if nipple height difference exceeded 6 mm.
  • Surgical method (purse-string suture or star flap) selected based on scarring and residual projection.

Main Results:

  • 27 secondary nipple reconstructions performed: 19 purse-string sutures, 8 star flaps.
  • Acceptable projection (>5 mm) achieved in 53% of purse-string cases and 75% of star flap cases.
  • Overall patient satisfaction was high (73% scored 4 or 5).

Conclusions:

  • Secondary nipple reconstruction can achieve appropriate projection.
  • Method selection (star flap vs. purse-string suture) is crucial based on patient-specific factors.
  • Favorable outcomes support these techniques for nipple revision.