Kawai Kenichiro, Fujiwara Toshihiro, Nishimoto Soh, Ishise Hisako, Saito Takuya, Nakajima Koyo, Kubo Tateki, Kakibuchi Masao
From the Department of Plastic Surgery, Hyogo Medical University, Nishinomiya, Japan.
Department of Plastic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Plast Reconstr Surg Glob Open. 2023 Jul 17;11(7):e5134. doi: 10.1097/GOX.0000000000005134. eCollection 2023 Jul.
Nipple hypertrophy is a relatively common phenomenon, particularly in the Asian patient population. The incidence and prevalence or cause of nipple hypertrophy are not well defined in the literature. As survival rates for breast cancer patients continue to improve, there is an increasing emphasis on enhancing their quality of life. Treatment options, such as lumpectomy and radiation therapy or mastectomy, now prioritize preservation of the nipple-areolar complex (NAC) through techniques like nipple-sparing mastectomy (NSM). This approach has been shown to improve patient satisfaction and quality of life. However, it is important to note that NSM is associated with certain complications, including NAC necrosis, malposition, and local recurrence of the tumor. Among those complications, nipple hypertrophy is quite rare. In this report, we present a case of nipple hypertrophy that developed after breast reconstruction, using autologous tissue. The patient, a 48-year-old woman, underwent NSM for breast cancer, and had a tissue expander placed simultaneously. Following tissue expansion, breast reconstruction with a deep inferior epigastric perforator (DIEP) flap was performed. However, during the tissue expansion phase, the patient's nipple gradually enlarged, and the protrusion became more pronounced after the DIEP flap transfer. Nipple reduction surgery was subsequently performed for both diagnostic and cosmetic purposes. We present this case along with a review of relevant literature.
乳头肥大是一种相对常见的现象，在亚洲患者群体中尤为如此。乳头肥大的发病率、患病率或病因在文献中尚无明确界定。随着乳腺癌患者生存率的不断提高，人们越来越强调提高他们的生活质量。诸如肿块切除术、放射治疗或乳房切除术等治疗方案，现在通过保留乳头乳房切除术（NSM）等技术将保留乳头乳晕复合体（NAC）作为优先考虑。这种方法已被证明可以提高患者满意度和生活质量。然而，需要注意的是，NSM与某些并发症相关，包括NAC坏死、位置异常和肿瘤局部复发。在这些并发症中，乳头肥大相当罕见。在本报告中，我们介绍了一例自体组织乳房重建后发生乳头肥大的病例。该患者为一名48岁女性，因乳腺癌接受了NSM，并同时置入了组织扩张器。在组织扩张后，采用腹壁下深动脉穿支（DIEP）皮瓣进行了乳房重建。然而，在组织扩张阶段，患者的乳头逐渐增大，在DIEP皮瓣转移后突出变得更加明显。随后为了诊断和美容目的进行了乳头缩小手术。我们展示此病例并对相关文献进行综述。
