La reconstruction de la plaque aréolomamelonnaire: résultats à long terme

Bodin, F.; Bruant-Rodier, C.; Lutz, Jean-Christophe; Himy, S.; Wilk, A

doi:10.1016/j.anplas.2007.06.004

Cited by 18 publications

(5 citation statements)

References 25 publications

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“…The usage of the purse-string suture technique for the periareolar skin closure has been reported to reduce the expansion of the areola and the loss of nipple projection (Weinfeld et al 2008 ; Caterson et al 2015 ). Bodin et al suggested that removing a part of the contralateral nipple and areola might be the most effective technique in terms of stable long-term results (Bodin et al 2008 ). Although we did not assess the efficacy of these published techniques in the present study, they may be useful to prevent the expansion of the donor NAC.…”

Section: Discussionmentioning

confidence: 99%

The optimal reconstruction size of nipple-areola complex following breast implant in breast cancer patients

et al. 2016

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BackgroundChanges in the areola size after reconstruction of the nipple-areola complex (NAC) following mastectomy and breast reconstruction with a silicon implant in primary breast cancer patients have not been well examined. This study aimed to investigate time-dependent changes in the size of the donor and graft NACs and to assess clinical factors influencing these changes.MethodsFifty-eight consecutive patients who underwent nipple-areola reconstruction were retrospectively evaluated. Nipple-areola diameter was measured immediately after the NAC reconstruction and at each follow-up visit for at least 36 months.ResultsThe donor NAC constituted 81 % of the graft NAC at the time of operation. The size of the donor NAC gradually increased by up to 36.8 % after the operation. The size of the graft NAC showed a decrease by 4.5 % at 7 months, followed by recovery to the initial value. The ratio of the donor site size to the graft site size was increased at month 1 and then showed a gradual decrease to 1.08 at 36 months. A history of mastopexy or reduction for the donor site was independent factors associated with changes in the NAC size.ConclusionsTo achieve symmetry, the diameter of the donor NAC immediately after the reconstruction should be at least 20 % smaller than that of the graft NAC, especially for patients without a history of additional operations.

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Section: Discussionmentioning

confidence: 99%

The optimal reconstruction size of nipple-areola complex following breast implant in breast cancer patients

et al. 2016

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“…16,18–21 In addition, although free nipple grafting has demonstrated superior nipple projection maintenance over local flaps, their use is obligatorily restricted to unilateral reconstructions, and many patients are not suitable candidates because of their anatomy or choose not to disrupt their uninvolved nipple. 22–24 Furthermore, free nipple grafts demonstrate meaningfully different biomechanical properties from the native nipple because of the dense connective tissue that forms within the neonipple, and complications such as scar contracture, nipple necrosis, or delayed wound healing may occur. 23–26…”

mentioning

confidence: 99%

“…22–24 Furthermore, free nipple grafts demonstrate meaningfully different biomechanical properties from the native nipple because of the dense connective tissue that forms within the neonipple, and complications such as scar contracture, nipple necrosis, or delayed wound healing may occur. 23–26…”

mentioning

confidence: 99%

“…16,[18][19][20][21] In addition, although free nipple grafting has demonstrated superior nipple projection maintenance over local flaps, their use is obligatorily restricted to unilateral reconstructions, and many patients are not suitable candidates because of their anatomy or choose not to disrupt their uninvolved nipple. [22][23][24] Furthermore, free nipple grafts demonstrate meaningfully different biomechanical properties from the native nipple because of the dense connective tissue that forms within the neonipple, and complications such as scar contracture, nipple necrosis, or delayed wound healing may occur. [23][24][25][26] Our previous proof-of-principle work has described the maintenance of neonipple volume and biomechanical properties of three-dimensionally (3D)-printed polylactic acid scaffolds filled with mechanically processed human costal cartilage (CC) from microsurgical breast reconstruction cases after 3 months in vivo.…”

mentioning

confidence: 99%

“…[22][23][24] Furthermore, free nipple grafts demonstrate meaningfully different biomechanical properties from the native nipple because of the dense connective tissue that forms within the neonipple, and complications such as scar contracture, nipple necrosis, or delayed wound healing may occur. [23][24][25][26] Our previous proof-of-principle work has described the maintenance of neonipple volume and biomechanical properties of three-dimensionally (3D)-printed polylactic acid scaffolds filled with mechanically processed human costal cartilage (CC) from microsurgical breast reconstruction cases after 3 months in vivo. 27 However, polylactic acid, which takes at least 3 to 5 years to degrade within the body, is an inappropriate biomaterial for this application because the prolonged rigidity of the neonipple would likely be a source of patient dissatisfaction, and the excessive stiffness would increase the risk of scaffold erosion or extrusion in a manner similar to an autologous cartilage graft.…”

mentioning

confidence: 99%

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Long-term Maintenance of Projection of Nipples Reconstructed Using 3D-printed Poly-4-Hydroxybutyrate (P4HB) Bioabsorbable Scaffolds

Dong

Shih

Premaratne

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: For patients who are unable to undergo nipple-sparing mastectomy, reconstruction of the nipple-areola complex has been shown to promote greater satisfaction in cosmetic outcome, body image, and sexual relationships. Although a variety of techniques have been developed to optimize the shape, size, and mechanical properties of the reconstructed nipple-areola complex, maintenance of sustained nipple projection over time remains a challenge for plastic surgeons. Methods: Three-dimensionally printed poly-4-hydroxybutyrate (P4HB) scaffolds were designed and fabricated filled with either mechanically minced or zested patient-derived costal cartilage, designed with an internal P4HB lattice (rebar) to provide interior structure to foster tissue ingrowth, or left unfilled. All scaffolds were wrapped within a C-V flap on the dorsa of a nude rat. Results: One year after implantation, neonipple projection and diameter were well preserved in all scaffolded groups compared with nonscaffolded neonipples (P < 0.05). Histologic analysis showed significant vascularized connective tissue ingrowth at 12 months in both empty and rebar-scaffolded neonipples and fibrovascular cartilaginous tissue formation in mechanically processed costal cartilage–filled neonipples. The internal lattice promoted more rapid tissue infiltration and scaffold degradation and best mimicked the elastic modulus of the native human nipple after 1 year in vivo. No scaffolds extruded or caused any mechanical complications. Conclusions: Three-dimensionally printed biodegradable P4HB scaffolds maintain diameter and projection while approximating the histologic appearance and mechanical properties of native human nipples after 1 year with a minimal complication profile. These long-term preclinical data suggest that P4HB scaffolds may be readily translated for clinical application. Clinical Relevance Statement: The authors’ unique, three-dimensionally printed P4HB scaffolds can be used to create custom nipple scaffolds that contour to any nipple shape and size, enabling the fabrication of tissue-engineered neonipples with significantly greater projection maintenance and closely approximating desired nipple biomechanical properties.

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Nipple Reconstruction Using a Star Flap Enhanced by Scar Tissue: The Regina Elena Cancer Institute Experience

Gullo¹,

Buccheri²,

Pozzi³

et al. 2011

Aesth Plast Surg

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La reconstruction de la plaque aréolomamelonnaire: résultats à long terme

Cited by 18 publications

References 25 publications

The optimal reconstruction size of nipple-areola complex following breast implant in breast cancer patients

The optimal reconstruction size of nipple-areola complex following breast implant in breast cancer patients

Long-term Maintenance of Projection of Nipples Reconstructed Using 3D-printed Poly-4-Hydroxybutyrate (P4HB) Bioabsorbable Scaffolds

Nipple Reconstruction Using a Star Flap Enhanced by Scar Tissue: The Regina Elena Cancer Institute Experience

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