Nipple reconstruction with four-lobe composite auricular graft

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Nipple reconstruction is a critical component of breast reconstruction.
• Existing techniques may face challenges with projection, symmetry, or donor site morbidity.

Purpose of the Study:

• To describe a new nipple reconstruction method using a four-lobe free composite graft from the earlobe.
• To evaluate the technique's efficacy in achieving long-term nipple projection and aesthetic outcomes.

Main Methods:

• A four-lobe free composite graft was harvested from the inferior pole of the earlobe, shaped like a clover leaf.
• Invagination of the graft flaps was performed to create nipple projection.
• Graft color and donor site appearance were assessed post-operatively.

Main Results:

• The technique successfully achieved long-term nipple projection without flattening.
• Donor site deformity was negligible, and ear piercing was preserved in desired cases.
• The transposed grafts maintained a pinkish hue, blending well with the pigmented areolar grafts.

Conclusions:

• This clover-leaf earlobe graft technique offers a viable option for nipple reconstruction.
• The method provides durable projection, good aesthetic integration, and minimal donor site issues.