Nipple reconstruction with complementary triangular flaps

Abstract

Background

Nipple reconstruction is a surgical procedure often performed after total breast reconstruction. The main limitation of all techniques is premature or excessive flattening of the reconstructed nipple. Over the past few years, we have modified the CV flap technique in order to increase the reconstructed nipple size and reduce premature flattening.

Methods

The modified technique proposes the addition of lateral and medial flaps which are drawn as two right triangles disposed symmetrically in a mirror-like fashion along the longitudinal axis. The symmetry between the two triangles allows the use of all the available height during creation of the new nipple. Once raised, flaps are rearranged into the shape of a nipple, trimmed only if necessary, and sutured. Diameter and projection of the reconstructed nipple were measured at 1 and 2 years and compared to immediate postoperative standard measures.

Results

Twenty-two patients underwent nipple reconstruction with this technique. Patients were followed up for 2 years. No complications were reported. Immediate postoperative standard measures of the reconstructed nipple were on average 1.3 cm in projection and 1.3 cm in diameter. After 1-year follow-up, the average projection was 0.61 cm ± 0.14 cm and the diameter was 1.13 ± 0.18 cm. After the 2-year follow-up, the average projection was 0.53 ± 0.16 and the diameter was 1.12 ± 0.18.

Conclusions

The modified nipple reconstruction technique herein presented is easy to perform and provides long-lasting results with a low risk of postoperative complications. Further studies to compare this technique with the traditional CV flap are warranted.

Level of Evidence: Level IV, therapeutic study.

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