Kargül G, Deutinger M
Klinische Abteilung für Wiederherstellende und Plastische Chirurgie, Universitätsklinik für Chirurgie, Universität Wien.
Handchir Mikrochir Plast Chir. 2001 Mar;33(2):133-7. doi: 10.1055/s-2001-12294.
Different methods have been used in our department for nipple-areola reconstruction. This study was undertaken in order to find out which method of reconstruction shows optimal long-term results. Between 1983 and 1999, breast reconstruction was performed in 204 patients and different methods were used for nipple-areola reconstruction. 91 patients could be examined. For areola reconstruction full-thickness skin grafts from the groin were used as well as skin grafts from the contralateral areola, vaginal mucosal grafts, and tattoos. For nipple reconstruction we used nipple sharing, labium grafts, local flaps, and a tattoo. Areola reconstruction with full-thickness skin grafts from the groin was performed in 45 patients, in 16 patients a graft from the contralateral areola was used and in 19 patients the technique of intradermal tattoo was applied. One patient had a vaginal mucosal graft, in another patient the nipple areola complex was transplanted to the groin after mastectomy for later reconstruction. Nipple projection was measured and the colour of the reconstructed areola was compared to the other side. Concerning the match of colour, best results were achieved with grafting from the contralateral areola, followed by areola tattoo and skin grafts from the groin. The vaginal mucosal graft was too dark. The transplanted original nipple-areola complex maintained its colour. Nipple projection between 3 and 4 mm was achieved by nipple sharing and local flaps. With grafts from the labium, a projection from 1 to 2 mm was achieved. Thus, best results were achieved by nipple sharing, local flaps for nipple reconstruction and areola skin grafts from the contralateral side. Vaginal mucosal grafts and grafts from the labium are not recommended.
我们科室采用了不同的方法进行乳头乳晕重建。开展这项研究是为了找出哪种重建方法能呈现出最佳的长期效果。1983年至1999年间，对204例患者进行了乳房重建，并采用不同方法进行乳头乳晕重建。其中91例患者接受了检查。乳晕重建采用了腹股沟全厚皮片、对侧乳晕皮片、阴道黏膜移植片以及纹身法。乳头重建采用了乳头共享、阴唇移植、局部皮瓣以及纹身法。45例患者采用腹股沟全厚皮片进行乳晕重建，16例患者使用对侧乳晕皮片，19例患者应用了皮内纹身技术。1例患者采用了阴道黏膜移植片，另1例患者在乳房切除术后将乳头乳晕复合体移植到腹股沟以备后期重建。测量了乳头突出度，并将重建乳晕的颜色与另一侧进行比较。在颜色匹配方面，对侧乳晕移植效果最佳，其次是乳晕纹身和腹股沟皮片移植。阴道黏膜移植片颜色过深。移植的原乳头乳晕复合体保持了其颜色。通过乳头共享和局部皮瓣，乳头突出度达到3至4毫米。采用阴唇移植片时，突出度为1至2毫米。因此，乳头重建采用乳头共享和局部皮瓣以及对侧乳晕皮片移植效果最佳。不推荐使用阴道黏膜移植片和阴唇移植片。
