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Cylindrical nipple reconstruction using an H flap

G G Hallock¹, J A Altobelli

¹Division of Plastic Surgery, Allentown Hospital, PA.

Annals of Plastic Surgery

|January 1, 1993

Summary

This study introduces an H-shaped local flap for nipple reconstruction, offering improved projection and a natural shape, especially for breasts with thin subcutaneous tissue after implantation.

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Area of Science:

Plastic and reconstructive surgery
Nipple-areola reconstruction techniques

Background:

Nipple reconstruction is a critical final stage in breast reconstruction.
Existing techniques for nipple creation have limitations, particularly for breasts with thin subcutaneous tissue, such as those following implantation.
Local flaps utilizing a central subcutaneous core are a common approach.

Purpose of the Study:

To present a novel H-shaped local flap technique for nipple reconstruction.
To address the challenges of achieving adequate projection and a natural shape in nipple creation, especially in cases with limited subcutaneous tissue.
To offer an alternative to existing central-core flap designs that may result in bulbous appearances.

Main Methods:

Introduction of the H-shaped local flap, a modification of central subcutaneous core flaps.
Utilizing large, well-vascularized side tabs for flap design.
Focusing on achieving a cylindrical shape geometrically similar to a natural nipple.

Main Results:

The H-shaped flap provides adequate projection for nipple reconstruction.
The technique minimizes the risk of flap slough due to robust vascularization.
The resulting nipple shape is cylindrical and avoids the bulbous appearance common with other central-core flaps.

Conclusions:

The H-shaped local flap is a viable and effective technique for nipple reconstruction.
This method offers improved aesthetic outcomes, particularly for patients with thin subcutaneous layers.
It presents a valuable alternative for achieving natural-looking nipple-areola reconstruction.

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