Immediate Nipple Reconstruction With Areolar Flaps After Nipple Excision

Area of Science:

• Oncology
• Plastic Surgery
• Breast Surgery

Background:

• Nipple-sparing mastectomy (NSM) is a common breast cancer surgery.
• Positive nipple margins after NSM typically require nipple-areola complex excision.
• This standard approach can lead to undesirable aesthetic outcomes.

Purpose of the Study:

• To present a novel technique for managing positive nipple margins after NSM.
• To evaluate nipple-only excision with immediate areolar flap reconstruction.
• To assess oncologic and aesthetic outcomes of this innovative approach.

Main Methods:

• Retrospective review of 6 patients undergoing NSM with positive nipple margins.
• Nipple-only excision followed by immediate reconstruction using "sickle" flaps.
• Analysis of oncologic results and aesthetic outcomes.

Main Results:

• The technique was applied to 5 cases of ductal carcinoma in situ and 1 invasive ductal carcinoma.
• All patients achieved good aesthetic results post-reconstruction.
• Oncologic outcomes were not compromised by the nipple-sparing approach.

Conclusions:

• Nipple-only excision with immediate areolar sickle flap reconstruction is a viable option for positive nipple margins after NSM.
• This method provides favorable aesthetic results.
• It offers a way to preserve the nipple-areola complex in select cases without negatively impacting cancer control.