Department of Plastic Surgery, Medical University of Gdansk, Debinki Str 7, 80-211 Gdansk, Poland.
Breast. 2011 Apr;20(2):124-8. doi: 10.1016/j.breast.2010.10.001. Epub 2010 Nov 5.
Nipple-areola complex (NAC) is a unique part of the human body. Not only is it a functional structure, but it plays an aesthetic role as well. It offers the final touch to the convex shape of the breast. Its lack frequently leads to depression in patients. This paper describes the method used by the authors for reconstructing nipple mound projection in patients following an autologous breast reconstruction procedure. To reconstruct the nipple mound an adapted local C-V flap technique described by Losken was used, with a silicone rod to support the nipple. The new method is based on simple preparation of flaps, fixing the silicone rod at the nipple bottom and below the top, it is quick and efficient in terms of time and materials used. The procedure was conducted in 30 patients: 10 cases following LDf reconstruction and Becker prosthesis or expander prosthesis, 20 cases following body tissue reconstruction with TRAM flap (Transverse Rectus Abdominis Musculocutaneous flap). All the patients who had undergone the LDf procedure developed flap necrosis followed by rod removal. In the patients who had undergone TRAM flap reconstruction no necrosis or wound split was observed, healing progressed without complications. In this group durable nipple projection was achieved. The new method for reconstructing nipple projection may be applied both in simultaneous and staged procedures, only in patients who have undergone autologous breast reconstruction procedure.
乳头乳晕复合体（Nipple-areola complex，NAC）是人体的独特部位。它不仅具有功能性结构，还具有美学作用。它为乳房的凸形提供了最后的修饰。其缺失常常导致患者抑郁。本文描述了作者在自体乳房重建手术后重建乳头乳晕突出度的方法。为了重建乳头乳晕突出度，作者使用了 Losken 描述的改良局部 C-V 皮瓣技术，并用硅胶棒支撑乳头。新方法基于皮瓣的简单准备，将硅胶棒固定在乳头底部和顶部下方，在时间和材料使用方面快速高效。该手术在 30 名患者中进行：10 例为 LDf 重建后使用 Becker 假体或扩张器假体，20 例为使用 TRAM 皮瓣（Transverse Rectus Abdominis Musculocutaneous flap）进行自体组织重建。所有接受 LDf 手术的患者均出现皮瓣坏死，随后取出棒。在接受 TRAM 皮瓣重建的患者中，未观察到坏死或伤口裂开，愈合过程无并发症。在这组患者中，实现了持久的乳头突出度。重建乳头突出度的新方法可应用于同期和分期手术，仅适用于接受过自体乳房重建手术的患者。
