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

Gullo, Pierpaolo; Buccheri, Ernesto Maria; Pozzi, Marcello; Vita, Roy De

doi:10.1007/s00266-011-9677-0

Cited by 12 publications

(4 citation statements)

References 19 publications

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“…Nipple reconstruction was performed for 4 patients using our previously described technique [ 18 ] followed by tattooing the areola, for 4 patients using a tissue graft from the genitalia, and for 3 patients using a star flap.…”

Section: Resultsmentioning

confidence: 99%

Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia

Vita¹,

Pozzi²,

Zoccali³

et al. 2015

J Exp Clin Cancer Res

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IntroductionIn women with macromastia, a type IV skin sparing mastectomy is often required to achieve an aesthetically pleasing reconstruction. The introduction of “skin-reducing mastectomy”, which inserts a permanent prosthetic device into a large pouch made by the pectoralis major muscle and an inferior pedicle dermal flap, allows the surgeon to achieve a safe oncologic result plus a cosmetically satisfying reconstruction.ObjectiveWe report here our experience with the skin-reducing mastectomy with the aim of emphasizing the problems associated with the technique.Materials and methodA study was conduced from April 2009 to November 2012, 74 patients with breast cancer were selected then received a skin-reducing mastectomy. The enrolled women satisfied the criteria of Nava. Statistical analysis was conduced to estimate the significance of the outcome results and complication rate.ResultA total of 88 SRMs were performed and the outcomes were as follows: excellent in 34 patients, good in 21, and poor in 8. We recorded 25 % of adverse events and statistic helped us to identify patient related factors whose can increase the complications onset.ConclusionSkin-reducing mastectomy is an indispensable procedure to treat cancer in large and pendulous breasts.The correct patient selection is mandatory to reduce the not negligible complication risk. Skin reducing mastectomy when is well conduced allow to obtain good results with patient satisfaction but, like other breast-conserving surgeries, in some case is not the ultimate solution, because it may require some revisions to maintain the optimum results.To day it be consider relatively safe in selected patient and the gold standard in macormastia immediate reconstruction.

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Section: Resultsmentioning

confidence: 99%

Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia

Vita¹,

Pozzi²,

Zoccali³

et al. 2015

J Exp Clin Cancer Res

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“…3,4,16–19 Goh et al 20 was one of the few studies evaluating different NAC flap techniques and found equivocal levels of satisfaction between reconstruction techniques. Gullo et al 21 provided evidence that the star flap achieves good overall patient satisfaction among patients undergoing breast reconstruction. Jabor et al 22 evaluated numerous types of flaps (star, nipple sharing, keyhole, skate, S) and found equivocal satisfaction between techniques.…”

Section: Discussionmentioning

confidence: 99%

Techniques in Nipple Areolar Reconstruction: A Retrospective Analysis of Surgical Interventions and Patient-reported Satisfaction Scores

Baker,

Marxen,

Nguyen

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: Nipple areolar complex (NAC) reconstruction often signifies completion of the breast reconstruction process for some patients and has been shown to improve both psychosocial and sexual well-being. Several techniques have been described; however, there currently exists little evidence in the literature describing outcomes or patient satisfaction. Methods: A retrospective analysis of NAC reconstructions over the last decade was queried for patient demographics, operative technique, and postoperative outcomes. A standardized, validated survey was also utilized to evaluate overall satisfaction, with a focus on aesthetic outcome, shape, color, and projection. Results: Eighty-three patients were identified, with 49 (59.0%) completing the survey. The modalities used for reconstruction include the C-V flap (45.7%), the modified skate flap technique (42.2%), and free nipple grafting (FNG, 12.0%). No significant differences in age, BMI, or comorbidities were found among the three types. The most utilized donor site for skate flap reconstruction was the suprapubic area (37.1%). There were also no significant differences in complication rate (C-V 10.5%, FNG 10%, skate 5.7%, P = 0.630) or revision surgery (C-V 2.6%, FNG 0%, skate 5.7%, P = 0.732). The most common complication was nipple necrosis. Adjusting for time to follow-up using multivariate analysis, there was a significant difference in overall patient satisfaction when compared across all three techniques, with the modified skate flap having the highest mean overall satisfaction scores. Conclusions: NAC reconstruction can be completed safely and effectively with a variety of techniques. The modified skate flap technique was associated with high levels of patient satisfaction and a low complication rate.

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“…Sometimes, the choice results in the sacrifice of creating an additional scar to achieve optimal nipple position, thus abandoning the use of previous scars. The use of avascular scar tissue as a free graft harvested from a linear fragment of mastectomy scar, in combination with the healthy skin of a local flap, has been already proposed [10]. Nevertheless, the use of an adjacent mastectomy preexisting scar as donor-site for flaps harvesting has been avoided for many years due to the fear of flap ischemia and necrosis [11,12].…”

Section: Discussionmentioning

confidence: 99%

A Simple and Reliable Method of Nipple Reconstruction Using a Spiral Flap Made of Residual Scar Tissue

Torresetti

Scalise

Benedetto

2017

Nipple-Areolar Complex Reconstruction

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

Abstract: We maintain that the technique presented here is safe, easy to perform, and reproducible and improves the long-term projection of the reconstructed nipple.

Cited by 12 publications

References 19 publications

Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia

Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia

Techniques in Nipple Areolar Reconstruction: A Retrospective Analysis of Surgical Interventions and Patient-reported Satisfaction Scores

A Simple and Reliable Method of Nipple Reconstruction Using a Spiral Flap Made of Residual Scar Tissue

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