The “Nipple-Licus”: the Everted Umbilicus for Immediate Nipple Reconstruction in Mid-Abdominal Transverse Rectus Abdominis Myocutaneous Breast Reconstruction

Abstract

In this paper, we present a technique for immediate nipple reconstruction in two patients who underwent ipsilateral mid-abdominal transverse rectus abdominis myocutaneous breast reconstruction. The umbilical stalk and surrounding skin were included in the harvested flap. The flap was transferred and inset placing the umbilicus in the ideal nipple position. The umbilicus was then everted with traction, and its height was maintained with cerclage suturing, dermal grafts, and horizontal-to-vertical skin closure. This “nipple-licus” achieves immediate nipple reconstruction without a need for a second surgery or an additional donor site.

Keywords

• breast reconstruction
• nipple reconstruction
• tram flap
• micro-incision
• cerclage suture