Background: One of the main steps for satisfactory breast reconstruction is symmetrical nipple reconstruction in an ideal position and projection. Various techniques, using cartilage, bone, fat, and even hydroxyapatite crystals, have been proposed to overcome projection loss in late term.
Method: We present a new nipple reconstruction technique performed in 6 cases. In this technique, the nipple dome is nourished by a double pedicle and supported by lateral flaps. Nipple projection is secured with 4/0 nylon sutures, which are applied between pedicles. Skin excess is advanced to the donor areas of nipple flaps.
Results: All patients were discharged the day after the operation, and nipple flaps healed well. No projection loss was noted in the 8- to 12-month follow-up period. Areola shape and consistency were acceptable.
Conclusion: Due to the presence of a double pedicle, this technique is especially helpful for patients with possible circulatory problems. Tension-free closure and rich blood supply to the nipple dome prevent loss of projection in the late term.
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http://dx.doi.org/10.1097/SAP.0b013e318095a4ed | DOI Listing |
J Surg Case Rep
January 2025
Department of Plastic and Reconstructive Surgery, University of South Dakota Sanford School of Medicine, 1500 W. 22nd St. Suite 101, Sioux Falls, SD 57105, United States.
Achieving satisfactory nipple esthetics following skin-sparing or nipple-sparing mastectomy is an important element of ensuring positive patient outcomes. Several techniques used to reconstruct the nipple-areolar complex have been described in previous literature and have had success in securing good cosmetic outcomes. For patients with macrothelia, surgeons may employ a number of options in reducing nipple size.
View Article and Find Full Text PDFJPRAS Open
March 2025
Department of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.
Background: Gigantomastia is a disabling condition characterized by excess breast tissue. Historically, free nipple graft (FNG) has been preferred, prioritizing the nipple-areola complex (NAC) vascularity. The NAC-carrying pedicle technique, which is most commonly used in case of hypertrophy of the breast, has been suggested as a viable alternative for gigantomastia according to recent evidence, with reduced rates of NAC necrosis and improved outcomes.
View Article and Find Full Text PDFJ Plast Reconstr Aesthet Surg
November 2024
Division of Plastic and Reconstructive Surgery, Department of Surgery, Weill Cornell Medicine, Weill Cornell Medical College, New York, NY, USA. Electronic address:
Introduction: There is growing interest in understanding chest sensory function due to the significant morbidity associated with impaired sensation following nerve injury. While the baseline quantitative sensory and pain thresholds in female and male patients have been studied in various other anatomic areas, there is little knowledge on quantitative sensation at the chest as well as the presence of possible gender differences. Therefore, this study aimed to conduct a comprehensive quantitative sensory analysis to determine if female and male chests feel the same.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
December 2024
From the Department of Plastic Surgery, University of California Irvine Medical Center, Orange, CA.
Background: Successful nipple-areolar complex (NAC) reconstruction greatly influences patient outcomes for transgender patients undergoing chest masculinization. Despite the recent rise in case volume, little is known on designing the ideal NAC that maintains its aesthetics in dynamic settings. This study aimed to examine the characteristics of male NACs and their dimensional variability to help develop guidelines on designing the neo-NAC.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
December 2024
From Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, Newark, N.J.
Background: Given the public's tendency to overestimate the capability of artificial intelligence (AI) in surgical outcomes for plastic surgery, this study assesses the accuracy of AI-generated images for breast augmentation and reduction, aiming to determine if AI technology can deliver realistic expectations and can be useful in a surgical context.
Methods: We used AI platforms GetIMG, Leonardo, and Perchance to create pre- and postsurgery images of breast augmentation and reduction. Board-certified plastic surgeons and plastic surgery residents evaluated these images using 11 metrics and divided them into 2 categories: realism and clinical value.
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