Nipple reconstruction using the modified top hat flap with banked costal cartilage graft: long-term follow-up in 58 patients.
The long-term projection of nipple reconstruction is a challenge. Fifty-eight consecutive female patients underwent 58 nipple reconstructions with modified top hat flap with cartilage graft following breast reconstruction in 54 autologous tissues and 4 implants, respectively. The average neonipple size was 11.5 mm initially and 8.5 mm at a mean follow-up of 44.9 months (range, 24-65 months), with a mean decrease in projection of 26.1%. Thirty-three patients achieved an excellent result, 20 patients a good result, 3 patients a fair result, and 2 patients a poor result, respectively. The complication rate was 12.1% (7 of 58 cases), and there was no statistically significant difference between the immediate and delayed groups; the revision rate was 8.6% (5 of 58 cases). The modified top hat flap with banked costal cartilage graft provides a sustainable solution to the gradual loss of nipple projection, with few complications.
Cheng
Ming-Huei
MH
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan. minghueicheng@gmail.com
Rodriguez
Eduardo D
ED
Smartt
James M
JM
Cardenas-Mejia
Alexander
A
D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012272:Ribs / Q000637:transplantation*; D013524:Surgical Flaps