The ‘cigar roll’ flap for nipple areola complex reconstruction: A novel technique

Jamnadas-Khoda, Benjamin; Thomas, Rachael; Heppell, Simon

doi:10.1016/j.bjps.2011.03.012

Cited by 12 publications

(3 citation statements)

References 5 publications

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“…Published information for nipple-areola reconstruction reveals numerous surgical techniques and variable long-term results in terms of patient satisfaction and sustained nipple projection. Some of the different techniques and local flaps that are used for nipple reconstruction, besides the skate-flap, are the Marshall technique [ 4 ], the button-hole technique [ 5 ], the C-V flap [ 6 ], silicone rods [ 7 ], the star-flap [ 8 ], the cigar roll flap [ 9 ], the hamburger technique [ 10 ], the arrow-flap [ 11 ], the top-hat-flap [ 12 ], the Swiss Roll flap [ 13 ], and others. One of the main limitations to this retrospective case review is that it only evaluates the skate-flap technique in combination with the Biodesign NRC; however, this is the senior author's surgical technique of choice and this series demonstrates that the procedure is safe and reliable, with very low complication rates.…”

Section: Discussionmentioning

confidence: 99%

Biologic Collagen Cylinder with Skate Flap Technique for Nipple Reconstruction

Tierney¹,

Hodde

Changkuon

2014

Plastic Surgery International

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A surgical technique using local tissue skate flaps combined with cylinders made from a naturally derived biomaterial has been used effectively for nipple reconstruction. A retrospective review of patients who underwent nipple reconstruction using this technique was performed. Comorbidities and type of breast reconstruction were collected. Outcome evaluation included complications, surgical revisions, and nipple projection. There were 115 skate flap reconstructions performed in 83 patients between July 2009 and January 2013. Patients ranged from 32 to 73 years old. Average body mass index was 28.0. The most common comorbidities were hypertension (39.8%) and smoking (16.9%). After breast reconstruction, 68.7% of the patients underwent chemotherapy and 20.5% underwent radiation. Seventy-one patients had immediate breast reconstruction with expanders and 12 had delayed reconstruction. The only reported complications were extrusions (3.5%). Six nipples (5.2%) in 5 patients required surgical revision due to loss of projection; two patients had minor loss of projection but did not require surgical revision. Nipple projection at time of surgery ranged from 6 to 7 mm and average projection at 6 months was 3–5 mm. A surgical technique for nipple reconstruction using a skate flap with a graft material is described. Complications are infrequent and short-term projection measurements are encouraging.

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Section: Discussionmentioning

confidence: 99%

Biologic Collagen Cylinder with Skate Flap Technique for Nipple Reconstruction

Tierney¹,

Hodde

Changkuon

2014

Plastic Surgery International

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“…At present, as the psychological benefits of NAC reconstruction has been receiving more attention (26), several authors have begun to reconstruct the nipple and breast in a single stage to improve the overall patient satisfaction (27,28). However, technical consensus has not been established because the most common problem following nipple reconstruction is that projection of the new nipple tends to shrink at most over 50% by time (29,30). The projection of reconstructed nipple is influenced essentially by two factors: (I) retraction forces of surrounding and underlying tissues and (II) tissue contraction of the flap (31).…”

Section: Discussionmentioning

confidence: 99%

Simultaneous nipple reconstruction in autologous breast reconstruction

Lee¹,

Ryu²,

Lee³

et al. 2021

Gland Surg

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Background: Reconstruction of the nipple-areola complex is the final step in surgical restoration of the breast. Nipple-areola reconstruction was previously done after an interval of several months using variable techniques, often resulting in low projection and flattened breast mound over time. We present algorithm of simultaneous nipple reconstruction (SNR) that leaves adequate residual projection and naturally shaped breast mound.Methods: Forty patients underwent a skin-sparing mastectomy and nipple excision between October 2016 and December 2020. In the control group, 21 patients underwent delayed nipple reconstruction for 6 months after breast reconstruction. The experimental group of 19 patients underwent nipple and breast reconstruction simultaneously. We collected relevant information and photographs of nipple profiles of both groups in the preoperative, postoperative 6-month, and postoperative 1-year time periods. We also examined the ratio between the reconstructed and contralateral nipples.Results: Scores regarding patient satisfaction questionnaire averaged higher in experimental groups to every category. The control group's scores gradually declined over time and the experimental group showed lesser decline. At the 1-year postoperative follow-up, the mean projection of the immediately reconstructed nipple was approximately the same as the contralateral nipple at 91%, whereas the delayed reconstructed nipple resulted in a 77% ratio.Conclusions: Nipple reconstruction should no longer be considered as a secondary complement to immediate breast reconstruction. The nipple appears to be essential component of breast reconstruction for patient. SNR with immediate breast reconstruction is a simple and reliable technique, giving stable aesthetic results over time.

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“…In fact, the most common problem following nipple reconstruction is that projection of the new nipple tends to shrink with time, and reported figures for percentage projection loss vary significantly [11, 12]. …”

Section: Discussionmentioning

confidence: 99%

Skin-Sparing Mastectomy with Immediate Breast and Nipple Reconstruction: A New Technique of Nipple Reconstruction

Serra

Miglietta

Abonante

et al. 2013

Plastic Surgery International

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Background. Most women with breast cancer today can be managed with breast conservation; however, some women still require mastectomy for treatment of their disease. Skin-sparing mastectomy (SSM) with immediate reconstruction has emerged as a favorable option for many of these patients. The authors combined the SSM technique with the preservation of a small part of the areola with immediate nipple together with with breast reconstruction. Methods. In an 8-year-period 155 female patients (age: 20–52 years old; mean age: 37.5 years) with extensive ductal intraepithelial neoplasia (DIN) or invasive breast cancer were treated with areola skin sparing mastectomy with immediate nipple and breast reconstruction. Patients were followed up prospectively by the breast surgeon, the plastic surgeon, and the oncologist for complications and recurrence. Results. After treatment, only 2 cases (1.29%) had a local recurrence. 8 out of 155 (5.5%) patients developed early complications (infections, seroma, haematoma), and 5 out of 155 patients (3.22%) developed delayed complications (implant rotation, aestethic deterioration) in the post operative time period. The final aesthetic outcome was judged as positive in 150 out of 155 patients (96.78%). Conclusion. In our experience, immediate nipple reconstruction after skin-sparing mastectomy is a technically feasible procedure which can give excellent cosmetic results.

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The ‘cigar roll’ flap for nipple areola complex reconstruction: A novel technique

Cited by 12 publications

References 5 publications

Biologic Collagen Cylinder with Skate Flap Technique for Nipple Reconstruction

Biologic Collagen Cylinder with Skate Flap Technique for Nipple Reconstruction

Simultaneous nipple reconstruction in autologous breast reconstruction

Skin-Sparing Mastectomy with Immediate Breast and Nipple Reconstruction: A New Technique of Nipple Reconstruction

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