title: A new technique in nipple reconstruction: dome technique with double pedicle.
abstract: BACKGROUND
  One of the main steps for satisfactory breast reconstruction is symmetrical nipple reconstruction in an ideal position and projection. Various techniques, using cartilage, bone, fat, and even hydroxyapatite crystals, have been proposed to overcome projection loss in late term.
  
  
  METHODS
  We present a new nipple reconstruction technique performed in 6 cases. In this technique, the nipple dome is nourished by a double pedicle and supported by lateral flaps. Nipple projection is secured with 4/0 nylon sutures, which are applied between pedicles. Skin excess is advanced to the donor areas of nipple flaps.
  
  
  RESULTS
  All patients were discharged the day after the operation, and nipple flaps healed well. No projection loss was noted in the 8- to 12-month follow-up period. Areola shape and consistency were acceptable.
  
  
  CONCLUSIONS
  Due to the presence of a double pedicle, this technique is especially helpful for patients with possible circulatory problems. Tension-free closure and rich blood supply to the nipple dome prevent loss of projection in the late term.
authors.affiliation: Sisli Etfal Training and Research Hospital, Plastic and Reconstructive Surgery Clinic, Istanbul, Turkey. sonertat@yahoo.com
authors.forename: Soner
authors.initials: S
authors.lastname: Tatlidede
authors.forename: Aysin Karasoy
authors.initials: AK
authors.lastname: Yesilada
authors.forename: Onur
authors.initials: O
authors.lastname: Egemen
authors.forename: Lutfu
authors.initials: L
authors.lastname: Bas
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy; D009558:Nipples / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013536:Suture Techniques