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Cardiac Monitoring Snap Electrodes: a Simple Way to Confirm Pre-operative Nipple Reconstruction Location
Terri A. Zomerlei M.D., M.S.
Douglas M. Leppink M.D
The Ohio State University
2014-03-08
Presenter: Terri A. Zomerlei
Affidavit:
The research project presented here has not been previously published or presented at a conference. The work has been 100% that of the resident with editing assistance and photographs provided by Dr Douglas Leppink.
Director Name: Gregory Pearson M.D.
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
BACKGROUND
The creation of the nipple-areolar complex (NAC) is the final step of a breast reconstruction. Patients often have high expectations for this final portion of their reconstruction and may view the aesthetic outcomes more critically than the reconstruction of the breast mound.
METHODS
For pre-operative marking, the patients are examined in the sitting position. A mark is placed 18 cm inferior to the midclavicular line following the meridian, with the distance from the midline confirmed as symmetric. Cardiac monitoring snap electrodes are then placed with the snap overlying the point where the nipple placement was measured. The surgeon is then able to move the stickers to his/her gestalt until they are in visually pleasing positions. The patient is then provided some time alone to evaluate the NAC position and to adjust the marking stickers herself until she is pleased with the proposed placement. An added benefit is that the patients can evaluate the NAC placement in clothes which removes any interfering optical illusions provided by breast mound scars.
CONCLUSION
Not only because of the subjective nature of the NAC placement on a reconstructed breast, but also
because of the high expectations of patients, it is essential for patients themselves to become active participants in planning and positioning their nipple placement. The use of the snap electrodes allows for simple 3-dimensional pre-operative marking with the electrode diameter closely approximating the average NAC diameter of 4.0 cm.
