title: Immediate Nipple Reconstruction as Oncoplastic Breast Surgery: the Cigar Roll Flap with Inner Dermal Core Technique.
abstract: BACKGROUND
  Postoperative loss of projection is the most common problem following nipple reconstruction. Despite the various available nipple reconstruction techniques, a simple and reliable method that maintains nipple projection has not yet been developed. Here, we introduce a simple and feasible method for immediate nipple reconstruction-the cigar roll flap with inner dermal core technique-which is expected to maintain long-term nipple projection.
  
  
  METHODS
  Between January 2013 and August 2014, 23 breast cancer patients underwent unilateral nipple reconstruction using the cigar roll flap with inner dermal core technique during immediate breast reconstruction. The projection of the reconstructed nipple was measured at the time of surgery and after radiation therapy (average postoperative duration, 8 months).
  
  
  RESULTS
  The mean nipple projection at the time of surgery was 1.1 ± 0.2 cm. After radiation therapy, the mean projection was 1.0 ± 0.2 cm. The mean maintenance of nipple projection was 84.5 ± 5.3 %. No immediate or delayed major postoperative complications were noted in our series. Most of the patients were satisfied with the three-dimensional projection of the nipple.
  
  
  CONCLUSIONS
  The cigar roll flap with inner dermal core technique is a simple and reliable method for oncoplastic breast surgery during immediate nipple reconstruction and maintains constant projection without any major complications or donor-site morbidity.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors: Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Ami-dong 1-ga, Seo-gu, Busan, 602-739, Republic of Korea.
authors: Seokwon
authors: S
authors: Lee
authors: Younglae
authors: Y
authors: Jung
authors: Youngtae
authors: Y
authors: Bae
mesh_terms: D000328:Adult; D000368:Aged; D064592:Autografts; D001943:Breast Neoplasms / Q000601:surgery; D015331:Cohort Studies; D004954:Esthetics; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000098:blood supply / Q000637:transplantation*; D009558:Nipples / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology