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Reconstruction of the Nipple with Expendable Full Thickness Skin Graft
Marco Maricevich, MD, M Asher Schusterman, MD, Alexey Markelov, MD, Carolyn De La
Cruz, MD
University of Pittsburgh
2015-03-15
Presenter: Alexey Markelov
Affidavit:
Marco Maricevich
Director Name: Joseph Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Reconstruction of the Nipple with Full Thickness Skin Graft
Background
Creation of a nipple areola complex (NAC) allows the reconstructed breast to resemble a natural breast after oncological reconstruction. Mastectomy scars position at NAC area on the mound can prevent adequate blood supply to standard local flaps options, mainly the area of the flap designated to cover the top of the reconstructed nipple.
Methods
In patients with mastectomy scar located at NAC position on the mound, we describe a technique using full thickness graft to cover the top of reconstructed the nipple. Skin graft donor sites are expendable "dog ears" located on the lateral breast or abdominal donor site.
Results
A video displays our technique. The same full thickness skin graft used for the areola reconstruction is also used for our nipple reconstruction in combination with local flaps. The skin graft provides easy closure of the top of the nipple with no distortion of the tissues and, in our experience, helps with avoiding nipple projection loss.
Conclusion
Full thickness skin graft on the top of the reconstructed nipple in combination with local flaps is an easy and simple technique to provide an aesthetically pleasing NAC reconstructive outcome when mastectomy scars located at NAC area on the mound.
