Objective and subjective evaluation of donor-site morbidity after nipple sharing for nipple areola reconstruction

Haslik, Werner; Nedomansky, Jakob; Hacker, Stefan; Nickl, Stefanie; Schroegendorfer, K.

doi:10.1016/j.bjps.2014.10.023

Cited by 17 publications

(6 citation statements)

References 34 publications

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“…Loss of nipple projection and breast symmetry is another concerned question to patients and surgeons. It usually occurs within the first 3-6 months after reconstruction [6]. In our case, the projection of the contralateral nipple was not obvious and breast symmetry was well preserved after 24 months post operation, indicating the well aesthetic outcome of our surgery technique.…”

Section: Discussionmentioning

confidence: 49%

Complete Avulsion of the Nipple-Areolar Complex Treated by One-Stage Reconstruction Using a Graft In Situ

Y-H¹,

Q-W²,

Lu³

et al. 2022

austinjclincaserep

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Background: Cases of complete avulsion of the Nipple-Areolar Complex (NAC) due to trauma are rare. The avulsed NAC can be replanted in situ if the vessels and nerves were anastomosed appropriately. However, this type of surgery is more complex, and requires longer operation times and the surgeon with training and experience of anastomosis of small vessels. We are looking for a more simple and effective method, which can be widely used. Case Presentation: We reported a 19-year old girl whose left NAC had been completely avulsed by accident. We used a simple one-stage reconstruction surgery to modify the avulsed NAC as a tissue graft in situ. After 24 months, the reconstructed left nipple showed a similar appearance to the right. In addition, the patient showed high satisfaction with her breast appearance. Discussion: Tissue graft in situ might be a simple, safe and reliable surgical procedure for completely NAC post-avulsion transplantation.

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Section: Discussionmentioning

confidence: 49%

Complete Avulsion of the Nipple-Areolar Complex Treated by One-Stage Reconstruction Using a Graft In Situ

Y-H¹,

Q-W²,

Lu³

et al. 2022

austinjclincaserep

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“…Lewin et al suggested that the ideal NAC is located in the middle of the breast, vertically and slightly lateral to the midpoint horizontally [ 57 ], while Laschuk et al proposed the “rule of thirds”, according to which the areola should represent just under one third of the base width, and the nipple should represent about one third of the areolar diameter [ 58 ]. Nevertheless, surgeons will usually place the NAC on the point of highest projection on the breast mound [ 30 ], which often corresponds to a sternal notch-to-nipple distance of 19–21 cm and a nipple-to-inframammary fold distance of 7–8 cm [ 59 ]. In implant-based BR, Young Hong advises adding 0.5 cm to the sternal notch-to-nipple distance when replacing a tissue expander with a definitive implant, since capsular contracture is a common occurrence that should be taken into account [ 55 ].…”

Section: Resultsmentioning

confidence: 99%

“…The composite nipple is sutured on a de-epithelialized recipient area using interrupted sutures. Most authors advocate for the use of stitches to close the tip of the donor nipple [29], though Haslik et al favor second intention healing, which occurs in 10 days on average and provides an equally acceptable scar and sensibility [30]. Local flaps represent the most commonly described technique for nipple reconstruction [6,31].…”

Section: Nipple and Areola Reconstruction Techniquesmentioning

confidence: 99%

Guiding Nipple-Areola Complex Reconstruction: Literature Review and Proposal of a New Decision-Making Algorithm

et al. 2020

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Background Nipple-areola complex reconstruction (NAR) most commonly represents the finishing touch to breast reconstruction (BR). Nipple presence is particularly relevant to the patient’s psyche, beyond any shadow of doubt. Many reconstructive options have been described in time. Surgery is easy, but final result is often disappointing on the long run. Methods The goal of this manuscript is to analyze and classify knowledge concerning NAR techniques and the factors that influence success, and then to elaborate a practical evidence-based algorithm. Out of the 3136 available articles as of August 8th, 2020, we selected 172 manuscripts that met inclusion criteria, which we subdivided into 5 main topics of discussion, being the various NAR techniques; patient factors (including patient selection, timing and ideal position); dressings; potential complications and finally, outcomes/patient satisfaction. Results We found 92 articles describing NAR techniques, 41 addressing patient factors (out of which 17 discussed patient selection, 14 described ideal NAC location, 10 described appropriate timing), 10 comparing dressings, 7 studying NAR complications, and 22 addressing outcomes and patient satisfaction. We elaborated a comprehensive decision-making algorithm to help narrow down the choice among NAR techniques, and choose the correct strategy according to the various scenarios, and particularly the BR technique and skin envelope. Conclusions No single NAR technique provides definitive results, which is why we believe there is no “end-all be-all solution”. NAR must be approached as a case-by-case situation. Furthermore, despite NAR being such a widely discussed topic in scientific literature, we still found a lack of clinical trials to allow for more thorough recommendations to be elaborated. Level of Evidence III This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

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“…The surgeon can choose to use no sutures after graft removal and letting the donor nipple heal spontaneously, minimizing scarring preserving the natural appearance and good sensitivity of the donor nipple [ 56 ].…”

Section: Nipple Sharing Technique For Nipple Reconstructionmentioning

confidence: 99%

Nipple–Areola Complex Reconstruction

Sisti

2020

Medicina

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Objective and subjective evaluation of donor-site morbidity after nipple sharing for nipple areola reconstruction

Cited by 17 publications

References 34 publications

Complete Avulsion of the Nipple-Areolar Complex Treated by One-Stage Reconstruction Using a Graft In Situ

Complete Avulsion of the Nipple-Areolar Complex Treated by One-Stage Reconstruction Using a Graft In Situ

Guiding Nipple-Areola Complex Reconstruction: Literature Review and Proposal of a New Decision-Making Algorithm

Nipple–Areola Complex Reconstruction

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