Areola and Nipple Reconstruction

Guida, Carlo A.; Picchi, Alberto; Inzirillo, S

doi:10.1097/00006534-197510000-00020

Cited by 15 publications

(2 citation statements)

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“…Factors that predispose to loss of nipple projection include inadequacy of available subcutaneous tissue beneath the flaps, poorly designed flaps with scars that contract and pull the nipple inward, and external pressure from dressings or bras. Synthetic endoprostheses such as silicone have been advocated as a means to maintain projection (20,21), but these are associated with several complications, including infection, allergy and extrusion (22). Some of these complications can be avoided by the use of autologous tissues.…”

Section: Discussionmentioning

confidence: 99%

Patient Satisfaction Following Nipple Reconstruction Incorporating Autologous Costal Cartilage

Lipa

Addison

Neligan

2008

Canadian Journal of Plastic Surgery

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BACKGROUND: Nipple-areolar reconstruction completes postmastectomy breast reconstruction. Many techniques for nipple reconstruction have been described, and each has their advocates and critics. One of the frequent failings of most designs is loss of nipple projection with time. OBJECTIVES: To determine the effect of including autologous costal cartilage on patient satisfaction with their nipple reconstruction. METHODS: Sixty-eight patients were identified who had undergone fishtail flap nipple reconstruction following autologous free flap breast reconstruction between 1990 and 2004. Qualitative questionnaires, using Likert scales, were sent to each patient to specifically assess their satisfaction with their nipple reconstruction. RESULTS: Of 26 respondents (mean ± SEM follow-up period 3.7±3.6 years), 13 had undergone nipple reconstruction incorporating costal cartilage banked at the time of initial breast reconstruction, and the other 13 had no cartilage in their nipple reconstructions. While both groups would opt for nipple reconstruction again, patients with cartilage grafts incorporated into their reconstructions had overall satisfaction ratings 1.92 grades higher on average (not significant, P=0.12) than those without. This difference increased to 3.2 grades when the satisfaction of the patient's partner was taken into account (P<0.05). Improved satisfaction corresponded to higher scores for volume, consistency, texture, and particularly for projection and contour of the nipple (P<0.05). Although nipple morphology changed over time, there was a trend toward improved stability in the cartilage group. CONCLUSIONS: Patient satisfaction with nipple reconstruction can be improved by incorporating costal cartilage beneath the skin flaps. Superior contour and projection are sustained over time.

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Section: Discussionmentioning

confidence: 99%

Patient Satisfaction Following Nipple Reconstruction Incorporating Autologous Costal Cartilage

Lipa

Addison

Neligan

2008

Canadian Journal of Plastic Surgery

View full text Add to dashboard Cite

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“…Allogeneic and synthetic materials have similar complications, along with additional risks of exposure and overprojection. 1,3,14,16,17,21,35,36 The purpose of this article is to systematically review the literature surrounding the use of nipple augmentation materials, focus on the highest quality available evidence, and determine their efficacy in maintaining long-term nipple projection following reconstruction with an aim to help in clinical decision-making for plastic surgeons.…”

mentioning

confidence: 99%