Tatlidede Soner, Yesilada Aysin Karasoy, Egemen Onur, Bas Lutfu
Sisli Etfal Training and Research Hospital, Plastic and Reconstructive Surgery Clinic, Istanbul, Turkey.
Ann Plast Surg. 2008 Feb;60(2):141-3. doi: 10.1097/SAP.0b013e318095a4ed.
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.
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.
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.
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.
实现满意的乳房重建的主要步骤之一是在理想位置和突出度上进行对称的乳头重建。为克服后期突出度丧失的问题，已提出了多种技术，包括使用软骨、骨、脂肪甚至羟基磷灰石晶体。
我们介绍了一种在6例患者中实施的新乳头重建技术。在该技术中，乳头穹隆由双蒂提供营养，并由外侧皮瓣支撑。通过在蒂之间应用4/0尼龙缝线来确保乳头突出度。多余的皮肤被推进到乳头皮瓣的供区。
所有患者术后次日出院，乳头皮瓣愈合良好。在8至12个月的随访期内未发现突出度丧失。乳晕形状和质地可接受。
由于存在双蒂，该技术对可能存在循环问题的患者特别有帮助。无张力缝合以及乳头穹隆丰富的血液供应可防止后期突出度丧失。
