Usefulness of Free Nipple-Areola Complex Graft for Nipple Malposition after Nipple Sparing Mastectomy

Abstract

Purpose: This article identifies the advantage and disadvantage of a free nipple areola complex graft (FNACG) for nipple malposition which resulted from tissue-expander insertion and subsequently replaced with an implant after nipple sparing mastectomy (NSM). Methods: The subjects were three such patients treated using FNACG and who were followed up for at least one year postoperatively. The surgical outcome was assessed for symmetry of nipple-areola position, graft take, depigmentation, and shrinkage. Results: In all patients, the graft was accurately transferred to a position to achieve symmetry with the unaffected breast, and there was complete graft take in the areola by simple surgical design and techniques. No depigmentation of the areola was observed. The size of the areola was almost unchanged after grafting in two patients, but areolar shrinkage occurred in one other patient. There was complete graft take in the nipple in one patient and no depigmentation of the nipple was observed. Necrosis occurred at the tip of the nipple in two other patients. These patients had depigmentation, and the height of nipples decreased in proportion to the level of necrosis. Conclusion: FNACG can be a useful method if its advantages and disadvantages are well considered.

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K. Matsuzaki, "Usefulness of Free Nipple-Areola Complex Graft for Nipple Malposition after Nipple Sparing Mastectomy," Modern Plastic Surgery, Vol. 2 No. 4, 2012, pp. 87-90. doi: 10.4236/mps.2012.24021.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] J. Y. Petit, U. Veronesi, A. Luini, R. Orecchia, P. C. Rey, S. Martella, F. Didier, F. De Lorenzi, M. Rietjens, C. Garusi, A. Sonzogni, V. Galimberti, E. Leida, R. Lazzari and A. Giraldo, “When Mastectomy Becomes Inevitable: The Nipple-Sparing Approach,” Breast, Vol. 14, No. 6, 2005, pp. 527-531. doi:10.1016/j.breast.2005.08.028
[2] S. R. Colen, “Breast Reduction with Use of the Free Nipple Graft Technique,” Aesthetic Surgery Journal, Vol. 21, No. 3, 2001, pp. 261-271. doi:10.1067/maj.2001.116439
[3] A. S. Colwell, J. W. May Jr. and S. A. Slavin, “Lowering the Postoperative High-Riding Nipple,” Plastic and Reconstructive Surgery, Vol. 120, No. 3, 2007, pp. 596-599. doi:10.1097/01.prs.0000270283.64971.dd
[4] R. P. Gruber and H. W. Jones Jr., “The ‘Donut’ Mastopexy: Indications and Complications,” Plastic and Reconstructive Surgery, Vol. 65, No. 1, 1980, pp. 34-38. doi:10.1097/00006534-198001000-00007
[5] P. Berrino, E. Campora and P. Santi, “Postquadrantectomy Breast Deformities: Classification and Techniques of Surgical Correction,” Plastic and Reconstructive Surgery, Vol. 79, No. 4, 1987, pp. 567-572. doi:10.1097/00006534-198704000-00010
[6] S. A. Slavin, S. M. Love and N. L. Sadowsky, “Reconstruction of the Radiated Partial Mastectomy Defect with Autogenous Tissues,” Plastic and Reconstructive Surgery, Vol. 90, No. 5, 1992, pp. 854-865. doi:10.1097/00006534-199211000-00022
[7] B. A. Frenkiel, M. D. Pacifico, M. Ritz and G. Southwick, “A Solution to the High-Riding Nipple-Areola Complex,” Aesthetic Plastic Surgery, Vol. 34, No. 4, 2010, pp. 525-527. doi:10.1007/s00266-009-9421-1
[8] H. Mohmand and A. Naasan, “Double U-Plasty for Correction of Geometric Malposition of the Nipple-Areola Complex,” Plastic and Reconstructive Surgery, Vol. 109, No. 6, 2002, pp. 2019-2022. doi:10.1097/00006534-200205000-00036
[9] A. K. Ahmed, D. E. Hahn, J. J. Hage, E. M. Bleiker and L. A. Woerdeman, “Temporary Banking of the Nipple-Areola Complex in 97 Skin-Sparing Mastectomies,” Plastic and Reconstructive Surgery, Vol. 127, No. 2, 2011, pp. 531-539. doi:10.1097/PRS.0b013e3181fed578
[10] H. P. Dustan, “Does Keloid Pathogenesis Hold the Key to Understanding Black/White Differences in Hypertension Severity?” Hypertension, Vol. 26, No. 6, 1995, pp. 858-862.
[11] D. D. Datubo-Brown, “Keloids: A Review of the Literature,” British Journal of Plastic Surgery, Vol. 43, No. 1, 1990, pp. 70-77. doi:10.1016/0007-1226(90)90047-4

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