Sue Gloria R, Seither Jennifer G, Nguyen Dung H
Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford Health Care, 770 Welch Road, Suite 400, Stanford, CA 94304, USA.
JPRAS Open. 2019 Nov 5;23:19-25. doi: 10.1016/j.jpra.2019.10.003. eCollection 2020 Mar.
Breast reconstruction improves the psychological well-being of patients with breast cancer. Patients who complete nipple-areolar reconstruction are even more satisfied with their final reconstructive result. Nipple flattening is a common complication. We hypothesized that injectable soft-tissue filler can be used to augment nipple projection in patients who underwent breast reconstruction.
This is a retrospective study of patients who underwent breast reconstruction and desired an enhanced postoperative nipple projection. The patients underwent a single session of injection with a hyaluronic acid filler as an outpatient. The filler was injected intradermally at the base of the nipple until the desired nipple projection was obtained.
Twelve patients and 22 breasts were included in this study. Enhanced nipple projection was observed in all cases, with an average increase of 3.0 mm in nipple height (range 2.5-4.5 mm). All injected nipples remained soft to the touch. All results were stable at a median of 7.5 months follow-up. No complications were observed.
The use of injectable fillers for enhanced nipple projection is a useful adjunct treatment in patients undergoing breast reconstruction. Advantages include the ability to obtain nipple projection in patients who opt to forgo nipple-areola reconstruction with local flaps, to augment reconstructed nipples in patients with thin mastectomy skin flaps especially following implant-based reconstruction, and to improve projection of the native nipple following nipple-sparing mastectomy. Another benefit of this adjunct treatment is that the injection is reversible. Filler injection is a safe and simple solution to the problem of insufficient nipple projection.
乳房重建可改善乳腺癌患者的心理健康。完成乳头乳晕重建的患者对最终的重建效果更为满意。乳头扁平是一种常见的并发症。我们推测可注射软组织填充剂可用于增加接受乳房重建患者的乳头突出度。
这是一项对接受乳房重建且希望术后乳头突出度增加的患者的回顾性研究。患者作为门诊病人接受了一次透明质酸填充剂注射。填充剂在乳头基部皮内注射，直至获得所需的乳头突出度。
本研究纳入了12例患者和22个乳房。所有病例均观察到乳头突出度增加，乳头高度平均增加3.0毫米（范围2.5 - 4.5毫米）。所有注射后的乳头触摸起来仍很柔软。在中位随访7.5个月时，所有结果均稳定。未观察到并发症。
使用可注射填充剂增加乳头突出度是乳房重建患者的一种有用的辅助治疗方法。优点包括能够在选择放弃使用局部皮瓣进行乳头乳晕重建的患者中获得乳头突出度，在乳房切除皮瓣薄的患者中，尤其是在植入物重建后，增加重建乳头的突出度，以及在保留乳头的乳房切除术后改善天然乳头的突出度。这种辅助治疗的另一个好处是注射是可逆的。填充剂注射是解决乳头突出度不足问题的一种安全、简单的方法。
