title: Nipple reconstruction: the top hat technique.
abstract: A new surgical technique was evaluated in 23 nipple-areola complex reconstructions in 18 consecutive patients who underwent breast reconstruction techniques. The author used 2 rows of pursestring sutures, one at the base of the neonipple and the other at the periphery of the neoareola. The pursestring sutures act as a supporting platform. The nipple projection was created by suturing in a vertical fashion: 4 horizontal incisions creating 4 supporting pillars. The Montgomery tubercles were simulated by secondary healing of 2- or 3-mm randomly placed stab incisions in the neoareola. The micropigmentation of the nipple-areola complex was performed preferably 6 weeks before the nipple-areola reconstructions. The mean follow-up time was 18 months. The average nipple projection was 6 mm, and the average diameter was 10 mm. Two patients presented with partial loss of nipple projection. Overall, more than 90% of the patients were satisfied with this procedure.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical College of Georgia, Augusta, GA 30912-4080, USA. mgamboa@mcg.edu
authors.forename: G Mabel
authors.initials: GM
authors.lastname: Gamboa-Bobadilla
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009558:Nipples / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*