Nipple Reconstruction with a Modified S-Flap Technique

Lossing, Clas; Brongo, Sergio; Holmström, Hans

doi:10.1080/02844319850158606

Cited by 42 publications

(13 citation statements)

References 3 publications

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“…Few et al 7 reportaram uma projeção a longo prazo de 0,4 a 0,83 cm, usando uma modificação do retalho Star Flap. Lossing et al 8 reportaram 3,9 mm com uma técnica modificada do S Flap. Kroll et al 9 reportaram uma projeção média de 2,4 mm para uma modificação do Double-opposing tab Flap e 1,9 mm para o Star Flap.…”

Section: Introductionunclassified

Reconstrução do complexo areolo-papilar: do que dispomos atualmente?

Ramos¹,

Strassburger²,

Uebel³

et al. 2016

Rev Bras Mastologia

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RESUMOA reconstrução do complexo areolo-papilar finaliza a reconstrução da mama após a mastectomia e melhora a satisfação das pacientes com o resultado final. Esta fase é crítica para acrescentar o realismo e a simetria da mama. Dentre as várias técnicas descritas, o uso de retalhos locais apresenta melhores resultados, apesar das desvantagens como, perda excessiva da projeção do mamilo e dificuldade técnica em mamas reconstituídas com implantes mamários, devido à pouca gordura subcutânea. O objetivo deste artigo é realizar uma revisão sobre as técnicas a disposição atualmente respeito à reconstrução do completo areolo-papilar. ABSTRACT Reconstruction of the nipple-areola complex concludes breast reconstruction after mastectomy. This procedure improves patient satisfaction. This phase is critical to add realism and symmetry to the breast. Among the various techniques described, the use of local flaps presents better results IntroduçãoA reconstrução do complexo areolo-papilar (CAP) finaliza a reconstrução da mama após a mastectomia e melhora a satisfação das pacientes com o resultado final [1][2][3] . A reconstrução ideal deve proporcionar boa simetria, cor, textura e projeção, comparável com a mama normal 4 . Esta fase é crítica para acrescentar o realismo e a simetria da mama 3 . O primeiro retalho local para reconstrução do mamilo foi descrito por Berson 5 em 1946 e para sua realização eram utilizados três retalhos triangulares de pele total.Em 2005, Farhadi et al. 6 publicaram uma atualização sobre a reconstrução do CAP. Nesse artigo, eles apontam quatro princípios básicos descritos para obter sucesso: 1. O tempo ótimo para reconstrução ocorre aproximadamente entre 3 e 4 meses após a reconstrução mamária (embora alguns autores proponham a reconstrução mamilar simultânea a da mama). 2. Em uma reconstrução unilateral, o mamilo contralateral deve servir como modelo, adaptando a posição às assimetrias da mama residual.

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Section: Introductionunclassified

Reconstrução do complexo areolo-papilar: do que dispomos atualmente?

Ramos¹,

Strassburger²,

Uebel³

et al. 2016

Rev Bras Mastologia

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show abstract

“…Patients with a reconstructed nipple-areola complex are more satis ed with their reconstruction than patients who have not (21). There are numerous ways of reconstructing the nipple, which can be divided into local aps (2,4,8,9,15,16) and free grafts (3,7,14,17). The disadvantage of using local aps is that the structure of the nipple will not be normal, the "nipple'' will atten with time, and the scar around the reconstructed nipple can sometimes be dif cult to cover when tattooing the areola.…”

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confidence: 99%

Threshold of Tactile Perception After Nipple-Sharing: a Prospective Study

Edsander-Nord

Wickman

Hansson

2002

Scandinavian Journal of Plastic and Reconstructive Surgery and

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Reconstruction of the nipple-areola complex is the final procedure of a breast reconstruction. The method of choice in our department for nipple reconstruction is nipple-sharing and tattooing of the areola. Some patients are reluctant to use a part of the healthy nipple, as it is not fully known how the sensibility in the remaining donor nipple is affected by surgery. Twenty patients admitted to the hospital for nipple-sharing were invited to participate in the study. The tactile perception threshold of the donor nipple was assessed using von Frey monofilaments preoperatively, and 1, 6, and 12 months postoperatively. The patients' subjective impressions one year postoperatively were also evaluated. The donor nipple had regained sensibility to touch six months after nipple-sharing. All patients reported that the nipple felt the same as before surgery and could become erect. We therefore recommend the nipple-sharing technique for completion of a breast reconstruction.

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“…There are numerous different local tissue flap techniques. 8,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Three of the most commonly used flaps are the modified star flap, 40 the bell flap, 41 and the skate flap. 42 In general, the local tissue flaps are simple to perform and well-tolerated by patients, but they are prone to necrosis and plagued by ultimate loss of projection.…”

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confidence: 99%

Improving Long-Term Projection in Nipple Reconstruction Using Human Acellular Dermal Matrix

Holton

Haerian

Silverman

et al. 2005

Annals of Plastic Surgery

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Reconstructed nipples rapidly lose projection. We describe the use of human acellular dermal matrix (ADM) to improve long-term projection of nipple flaps. Athymic rats were randomized to 3 groups; each received 2 nipples: bell flap (control, n = 16 nipples), bell flap with a cylinder of implanted ADM (n = 24), or bell flap with intraflap injection of micronized ADM (MADM) (n = 10). Seven of 24 ADM nipples extruded (30%). By 12 weeks, the control nipples maintained 44% of initial projection compared with 70% for ADM nipples (P = 0.000025). The MADM nipples maintained 49% of initial projection after 12 weeks (P = 0.55 compared with control). No MADM nipples extruded. ADM grafts maintain long-term projection better than local tissue flaps alone. We hypothesize that MADM may limit extrusion and allow for serial injection of nipples. Based on the promising results of this study, clinical trials are warranted using human ADM and/or human MADM for nipple reconstruction.

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Nipple Reconstruction with a Modified S-Flap Technique

Cited by 42 publications

References 3 publications

Reconstrução do complexo areolo-papilar: do que dispomos atualmente?

Reconstrução do complexo areolo-papilar: do que dispomos atualmente?

Threshold of Tactile Perception After Nipple-Sharing: a Prospective Study

Improving Long-Term Projection in Nipple Reconstruction Using Human Acellular Dermal Matrix

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