Nipple reconstruction with bipedicled dermal flap: a new and easy technique.
BACKGROUND
Nipple reconstruction is the last step in breast reconstruction. An entirely satisfying breast reconstruction can be achieved only with a symmetrically placed and ideally shaped nipple-areola complex. Several techniques and modifications have been described for nipple-areola reconstruction but long-term projection loss is still a problem in nipple reconstruction.


METHODS
Between January 2005 and October 2008, 13 female patients underwent 19 nipple reconstructions in our department. Among these patients, seven underwent breast reconstruction with a DIEP flap following unilateral mastectomy, and six were diagnosed with gigantomasty and underwent bilateral breast reduction with a modification of free nipple grafting. Our method for nipple reconstruction relies on a vertically oriented bipedicled flap with horizontally oriented extensions from the mid-portion.


RESULTS
Nineteen nipple reconstructions in 13 patients were evaluated and the mean follow-up period was 15 months. We did not see any necrosis or any significant projection loss in our cases. Patients' satisfaction was noted as high and the results were evaluated as pleasing.


CONCLUSIONS
We present a new technique that uses a bipedicled flap, oriented vertically. A rich blood supply to the flap may be the principal cause for long-lasting nipple projection.
Turgut
Gursel
G
Sisli Etfal State Hospital for Research and Training, 19 Mayis Mah. Celal Atik Sokak, Sisli-Istanbul, Turkey.
Sacak
Bulent
B
Görgülü
Tahsin
T
Yesilada
Aysin K
AK
Bas
Lutfu
L
D000328:Adult; D001940:Breast / Q000503:physiopathology / Q000601:surgery; D018427:Breast Implants; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery*; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome