title: Filler injection enhances the projection of the reconstructed nipple: an original easy technique.
abstract: BACKGROUND
  Reduced nipple projection is the main reason for unsatisfactory nipple-areola complex reconstruction, and many techniques have been proposed to maintain projection of the reconstructed nipple.
  
  
  METHODS
  For 70 patients, 90 nipples were reconstructed using either a small wedge from the labia minora (LMW) (n=70) or nipple sharing (NS) (n=20). Two months after reconstruction, each reconstructed nipple was injected with DermaLive. Second and third injections were performed 2 and 5 months later. The injected volume was tailored to the desired projection. Nipple projection was measured at the moment of implant, before and after each injection, and 6 and 12 months after the last injection.
  
  
  RESULTS
  Nipple projection was satisfactory in all cases and comparable with that of the contralateral nipple. The average nipple projection at 6 months was 5.8 mm in the LMW group and 3.8 mm in the NS group (p<0.01) and, respectively, 5.6 mm and 3.5 mm at 12 months (p<0.01). No complications occurred, except for one positron emission tomography (PET) false-positive result.
  
  
  CONCLUSIONS
  The described method is simple and safe. It provides precise projection with no need for intraoperative forecasting of tissue reabsorption. The result was better for the LMW patients, perhaps because of their higher distensibility.
authors.affiliation: Dipartimento di Discipline Chirurgiche, Rianimatorie e Dei Trapianti, Università degli Studi di Bologna, Policlinico S. Orsolo-Malpighi, 9-40128 Bologna (Bo), Italy. danilo.accorsi@fastwebnet.it
authors.forename: P
authors.initials: P
authors.lastname: Panettiere
authors.forename: L
authors.initials: L
authors.lastname: Marchetti
authors.forename: D
authors.initials: D
authors.lastname: Accorsi
mesh_terms: D000179:Acrylates / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D020100:Hydrogels / Q000008:administration & dosage*; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000534:rehabilitation; D009558:Nipples / Q000601:surgery* / Q000637:transplantation; D012092:Replantation / Q000379:methods; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors; D015626:Tissue Expansion / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000179:Acrylates; C482306:Dermalive; D020100:Hydrogels; D006820:Hyaluronic Acid