Bell flap nipple reconstruction--a new wrinkle

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Breast Reconstruction

Background:

• Nipple-areolar complex reconstruction is a crucial component of breast mound restoration.
• Existing techniques may require skin grafts or multiple stages, impacting patient outcomes.
• A simplified, effective method for nipple-areolar reconstruction is needed.

Purpose of the Study:

• To present a single-stage surgical technique for nipple reconstruction.
• To achieve a well-projected and pigmented nipple-areolar complex without skin grafts.
• To evaluate the efficacy of this technique in patients undergoing breast mound reconstruction.

Main Methods:

• A bell-shaped flap is elevated within a circular subcutaneous island flap.
• The bell-shaped flap is folded to form the nipple, and the surrounding flap is shaped into the areola.
• Pigmentation is achieved through tattooing, and projection is enhanced with a purse-string suture.

Main Results:

• The technique was successfully applied to six nipples in five patients over 2.5 years.
• Satisfactory to good aesthetic results were achieved for the nipple-areolar complex.
• The method is suitable for breast mounds reconstructed with musculocutaneous flaps or from breast reductions.

Conclusions:

• This single-stage technique offers a viable option for nipple-areolar reconstruction, avoiding skin grafts.
• It provides good projection and pigmentation, enhancing the aesthetic outcome of breast mound reconstruction.
• The technique is not recommended for breasts reconstructed solely with implants due to vascularity concerns.