Lee Joon Seok, Kwon Joon Hyun, Lee Jeong Woo, Choi Kang Young, Chung Ho Yun, Cho Byung Chae, Yang Jung Dug
Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
ANZ J Surg. 2019 Mar;89(3):E71-E75. doi: 10.1111/ans.14410. Epub 2018 Feb 8.
The final stage of breast reconstruction after mastectomy for breast cancer is nipple reconstruction. However, a consistent and reliable method resulting in the most ideal aesthetic results has yet to be clarified. This study analysed the long-term outcomes of nipple reconstruction using Rapiplug.
Forty-one patients who underwent immediate breast reconstruction after mastectomy between January 2014 and February 2017 were enrolled. Nipple reconstruction was performed with C-V flap and Hammond flap, and hat-shaped Rapiplug was implanted at the flap core. Nipple projection and width were measured and nipple reduction rates were calculated immediately after and at 3, 6, and 12 months after surgery. Patient satisfaction was surveyed at the 12-month follow-up and compared with patient characteristics and other variables.
Forty-one nipple reconstructions were performed in 41 patients. Most post-operative adverse events were resolved with conservative management, and revision was performed in only one case. The mean nipple projections were 8.9 ± 1.8, 7 ± 1.8, 5.6 ± 1.6 and 4.9 ± 1.6 mm immediately, and 3, 6 and 12 months after surgery, respectively, and the mean reduction rate of nipple size with reference to the size immediately after surgery was 22.2%, 37.2% and 44.7% at 3, 6 and 12 months after surgery, respectively. Patient satisfaction was 82.9% in overall outcome, and 85.3% of projection was good or excellent.
Rapiplug can improve the long-term preservation of nipple projection after nipple reconstruction and is considered to be consistent and reliable with good aesthetic outcomes and no severe complications.
乳腺癌乳房切除术后乳房重建的最后阶段是乳头重建。然而，一种能产生最理想美学效果的一致且可靠的方法尚未明确。本研究分析了使用Rapiplug进行乳头重建的长期效果。
纳入2014年1月至2017年2月间接受乳房切除术后即刻乳房重建的41例患者。采用C-V皮瓣和哈蒙德皮瓣进行乳头重建，并在皮瓣核心植入帽状Rapiplug。分别在术后即刻、术后3个月、6个月和12个月测量乳头突出度和宽度，并计算乳头缩小率。在12个月随访时调查患者满意度，并与患者特征及其他变量进行比较。
41例患者共进行了41次乳头重建。大多数术后不良事件通过保守治疗得到解决，仅1例进行了修复手术。术后即刻、3个月、6个月和12个月时乳头平均突出度分别为8.9±1.8、7±1.8、5.6±1.6和4.9±1.6mm，术后3个月、6个月和12个月时乳头大小相对于术后即刻大小的平均缩小率分别为22.2%、37.2%和44.7%。总体结果患者满意度为82.9%，85.3%的乳头突出度良好或优秀。
Rapiplug可改善乳头重建后乳头突出度的长期保持，被认为是一致且可靠的，具有良好的美学效果且无严重并发症。
