Lee Jong Ho, Ryu Jeong Yeop, Lee Jung Ho, Lee Jeeyeon, Park Ho Yong, Yang Jung Dug, Lee Joon Seok
Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
Gland Surg. 2021 Oct;10(10):2966-2977. doi: 10.21037/gs-21-338.
Reconstruction of the nipple-areola complex is the final step in surgical restoration of the breast. Nipple-areola reconstruction was previously done after an interval of several months using variable techniques, often resulting in low projection and flattened breast mound over time. We present algorithm of simultaneous nipple reconstruction (SNR) that leaves adequate residual projection and naturally shaped breast mound.
Forty patients underwent a skin-sparing mastectomy and nipple excision between October 2016 and December 2020. In the control group, 21 patients underwent delayed nipple reconstruction for 6 months after breast reconstruction. The experimental group of 19 patients underwent nipple and breast reconstruction simultaneously. We collected relevant information and photographs of nipple profiles of both groups in the preoperative, postoperative 6-month, and postoperative 1-year time periods. We also examined the ratio between the reconstructed and contralateral nipples.
Scores regarding patient satisfaction questionnaire averaged higher in experimental groups to every category. The control group's scores gradually declined over time and the experimental group showed lesser decline. At the 1-year postoperative follow-up, the mean projection of the immediately reconstructed nipple was approximately the same as the contralateral nipple at 91%, whereas the delayed reconstructed nipple resulted in a 77% ratio.
Nipple reconstruction should no longer be considered as a secondary complement to immediate breast reconstruction. The nipple appears to be essential component of breast reconstruction for patient. SNR with immediate breast reconstruction is a simple and reliable technique, giving stable aesthetic results over time.
乳头乳晕复合体的重建是乳房手术修复的最后一步。以前乳头乳晕重建是在间隔数月后采用多种技术进行的，随着时间的推移，常常导致乳头突出度低和乳房隆起变平。我们提出了一种同步乳头重建（SNR）算法，该算法能保留足够的剩余突出度并塑造出自然形态的乳房隆起。
2016年10月至2020年12月期间，40例患者接受了保留皮肤的乳房切除术和乳头切除术。在对照组中，21例患者在乳房重建后6个月进行了延迟乳头重建。19例患者的实验组同时进行了乳头和乳房重建。我们收集了两组患者术前、术后6个月和术后1年时间段乳头轮廓的相关信息和照片。我们还检查了重建乳头与对侧乳头之间的比例。
实验组患者满意度问卷各项得分平均更高。对照组得分随时间逐渐下降，而实验组下降幅度较小。术后1年随访时，即刻重建乳头的平均突出度与对侧乳头大致相同，比例为91%，而延迟重建乳头的比例为77%。
乳头重建不应再被视为即刻乳房重建的次要补充。乳头似乎是患者乳房重建的重要组成部分。即刻乳房重建的同步乳头重建是一种简单可靠的技术，随着时间推移能产生稳定的美学效果。
