Kim Young Chul, Yun Ji Young, Lee Hyung Chul, Yim Ji Hong, Eom Jin Sup
Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Republic of Korea.
Department of Plastic and Reconstructive Surgery, Inje University Busan Paik Hospital, Republic of Korea.
J Plast Reconstr Aesthet Surg. 2017 Feb;70(2):243-247. doi: 10.1016/j.bjps.2016.11.019. Epub 2016 Dec 14.
Numerous nipple reconstruction methods have been proposed including the use of local flaps and composite grafts, but most methods have shown a significant loss of projection. We combined a modified CV flap with a composite graft (nipple sharing) to maximize the projection and volume of the new nipple and reduce the size of the contralateral nipple.
In total, 30 patients underwent nipple reconstruction using a combined method between January 2013 and November 2015. This technique was selected if the diameter of the contralateral nipple was large and the thickness of the skin was less than 2 mm. After the modified CV flap was created, a composite graft from the contralateral nipple was placed between the V flaps and the C flap. The loss of projection and the ratio of the new nipple to the contralateral nipple were evaluated 12 months after surgery.
Nipple reconstruction was successful in all cases. The projection at 12 months after reconstruction was 68% of the initial projection, and the mean projection ratio of the new nipple to the contralateral nipple was 0.81. There was no complication in the donor nipple; in fact, the shape was improved with nipple reduction, and the scar was inconspicuous.
Nipple reconstruction that combines a modified CV flap and composite graft can maximize the nipple projection and provide a chance for nipple symmetry as the two components will act synergistically.
已经提出了多种乳头重建方法，包括使用局部皮瓣和复合移植，但大多数方法都显示出明显的突出度丧失。我们将改良的CV皮瓣与复合移植（乳头共享）相结合，以最大化新乳头的突出度和体积，并减小对侧乳头的大小。
2013年1月至2015年11月期间，共有30例患者采用联合方法进行乳头重建。如果对侧乳头直径较大且皮肤厚度小于2毫米，则选择该技术。制作改良的CV皮瓣后，将对侧乳头的复合移植物置于V皮瓣和C皮瓣之间。术后12个月评估突出度丧失情况以及新乳头与对侧乳头的比例。
所有病例乳头重建均成功。重建后12个月的突出度为初始突出度的68%，新乳头与对侧乳头的平均突出度比例为0.81。供体乳头无并发症；事实上，乳头缩小后形状得到改善，瘢痕不明显。
结合改良CV皮瓣和复合移植的乳头重建可以最大化乳头突出度，并为乳头对称提供机会，因为这两个组成部分将协同发挥作用。
