Nipple Reconstruction: The “Hammond” Flap

Dolmans, Guido H.; Kar, Annekatrien L. van de; Rappard, Julien H. A. van; Hoogbergen, Maarten M.

doi:10.1097/01.prs.0000300297.72188.e4

Cited by 16 publications

(10 citation statements)

References 4 publications

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“…Most nipple reconstruction techniques result in a loss of nipple projection over time, mainly due to fat resorption [1,12,13,22]. Even techniques which use a variety of implanted materials inside the nipple to compensate for inevitable fat resorption ultimately find that implants are resorbed, usually due to their non-autologous composition [20,23].…”

Section: Discussionmentioning

confidence: 99%

The weave technique for nipple reconstruction

Kim

Gust

Connor

et al. 2013

Journal of Plastic Surgery and Hand Surgery

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Traditional nipple reconstruction relies on local flap techniques. However, there are several problems associated with local flap reconstruction including loss of projection, widening of the base width, and difficulty working around the mastectomy scar. This study presents a variation of traditional local flap nipple reconstruction, which is termed the weave technique. Rather than using two flaps to create base width, the weave technique uses one. By controlling the base width, this may serve to sustain long-term projection. Second, filling the inside of the nipple with the second flap may contribute to longer term projection. Because there is no third flap, it is easier to orient the nipple with respect to the mastectomy scar. To date, the senior author has used this method to reconstruct 55 nipples in 40 patients, with 415 days (range 191-733) mean follow-up time. This includes 45 (82%) nipple reconstructions after tissue expander-implant reconstruction. The use of this technique has produced excellent aesthetic results with nipple projection and site healing. The majority of patients have been satisfied with their nipple reconstruction. Three patients had wound healing difficulties, including two (3.6%) that healed with conservative wound care and one (1.8%) in a radiated patient requiring surgical revision. There were no other revisions necessary and no infections. In summary, the weave technique is a suitable modification to the popular C-V technique that maintains the benefits and simplicity of the aforementioned flap while potentially reducing projection loss, conserving base width, and allowing greater flexibility for nipple placement.

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Section: Discussionmentioning

confidence: 99%

The weave technique for nipple reconstruction

Kim

Gust

Connor

et al. 2013

Journal of Plastic Surgery and Hand Surgery

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“…1). Thereafter, the effectiveness of the Hammond flap was confirmed by Dolmans et al [8] and Katsuragi et al [9] and the authors have used Hammond flaps in numerous cases of nipple reconstruction. Here, we aimed to determine the benefits of using the Hammond flap in nipple reconstruction by analyzing objective measurements and subjective patient satisfaction levels.…”

Section: Introductionmentioning

confidence: 90%

Our Experiences in Nipple Reconstruction Using the Hammond flap

Yang

Ryu

et al. 2014

Arch Plast Surg

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BackgroundNipple reconstruction following breast mound reconstruction is the final step in breast reconstruction. Although nipple reconstruction is a simple surgery, the psychological aspects of nipple reconstruction are thought to be important. Nipple projection is a key factor in determining patient satisfaction with the surgery. In the present study, the Hammond flap technique was introduced for nipple reconstruction.MethodsTwenty-six patients who had undergone breast reconstruction from February 2008 to March 2012 were enrolled in this prospective study. All patients were evaluated based on preoperative photos, and their nipple diameters and heights were measured. Postoperative evaluation was conducted 3, 6, 9, and 12 months following nipple reconstruction. A questionnaire on patient satisfaction with the nipple reconstruction was administered 12 months after nipple reconstruction. Moreover, the same plastic surgeon scored nipple projection and overall cosmetic result of the new nipple.ResultsThe mean projection was 4.4 mm (range, 3-6 mm), and it well matched the contralateral nipple. Twelve months following nipple reconstruction, the mean reduction rate in the nipple projection was 43.6%. Patients were satisfied or very satisfied with the nipple projection and the overall cosmetic result in 80.7% cases.ConclusionsIn the present study, compared with other techniques, the use of the Hammond flap technique in nipple reconstruction showed competitive results with regard to nipple projection and patient satisfaction.

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“…Most nipple reconstruction techniques result in a loss of projection, mainly due to fat resorption [16][17][18][19] This modified C-V flap technique using scar tissue as the flap provides more projection. The partial removal of subdermal fat while preserving the subdermal plexus might enable the inclusion of minimal subdermal fat within the flap, which may minimize fat resorption.…”

Section: Discussionmentioning

confidence: 99%

Nipple Reconstruction Using a Scar-Based Modified C-V Flap

Choi

Kim

et al. 2016

Arch Aesthetic Plast Surg

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INTRODUCTIONPatients who have lost their nipple-areolar complex (NAC) due to cancer excision surgery or trauma, or who have a congenital absence of the NAC, can experience psychological distress. Therefore, NAC reconstruction procedures have both physical and psychological impacts.Breast reconstruction is usually performed in multiple stages.Since reconstruction of the NAC finalizes breast reconstruction following mastectomy, it is important to perform this final step in a precise and delicate way with an optimal surgical technique. The 2 basic methods of NAC reconstruction are local flaps and composite grafts. The surgical techniques that have been developed for NAC reconstruction include the C-V flap, the star flap, the skate flap, the bell flap, and the arrow flap [1][2][3][4][5][6][7]. Local flaps are preferred because donor site morbidity is minimal compared to composite grafts. The C-V flap is a simple, quick, and effective method for nipple reconstruction using a local flap [8].In these surgical procedures, nipple creation and areola pigmentation are critical [9]. Successful and complete procedures for nipple reconstruction must be simple, reliable, and convenient, with good aesthetic outcomes. The scar-based modified C-V flap technique described in this study is based on the conventional C-V flap technique. The C-V flap is a simple method using a local flap, and can be performed in the outpatient department [9]. Of note, the scar-based modified C-V flap can be performed for nipple recon- Background Numerous techniques have emerged for nipple-areolar complex (NAC) over the years. Scar-based modified C-V flap technique is a new method for creating NAC, surgeons can accomplish nipple reconstruction and scar revision simultaneously. This article described the modified C-V flap technique for nipple reconstruction. This modified method is simple and reliable with good outcome. Methods To evaluate the effectiveness of our technique, we reviewed 21 patients who underwent nipple reconstruction using the scar-based modified C-V flap technique. For scar-based modified C-V flap, a C flap was designed to match the contralateral nipple in width while a V flap including scar after mastectomy was designed. The flap pedicle was centrally located. The V flap was then fixed surrounding the central part with a proper shape and volume considering the distal part of the flap that had poor vascularization. Results The average age of the 21 patients was 48.4 years. The average length of follow up was 7.4 months. Complication rate was 19.0% including projection loss in 2 cases, tip necrosis in 1 case, postoperative infection in 1 case, and wound dehiscence in 1 case. Reoperations were performed for 2 cases of projection loss, 1 case of partial flap necrosis, and 1 case of wound dehiscence. Conclusions The scar-based modified C-V flap technique is a simple and reliable method for nipple reconstruction with aesthetic outcome. Patients who have undergone this surgical technique tend to have great satisfaction with the results.

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Nipple Reconstruction: The “Hammond” Flap

Cited by 16 publications

References 4 publications

The weave technique for nipple reconstruction

The weave technique for nipple reconstruction

Our Experiences in Nipple Reconstruction Using the Hammond flap

Nipple Reconstruction Using a Scar-Based Modified C-V Flap

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