Nipple Reconstruction with a C-V Flap Overgrafted with AlloDerm

Abstract

Background Breast reconstruction involves several steps, culminating in the creation of the nipple-areolar complex. Numerous methods of nipple reconstruction have been attempted, and have all proven somewhat successful in providing tissue for projection. In this clinical study, we evaluated a new technique using an acellular dermal matrix (ADM; AlloDerm®) adjunct to a skin flap (C-V flap technique) in nipple reconstruction. Methods In 2016, 13 nipple reconstructions were performed using this technique. We designed the C-V flap in the proper position on the breast. After the skin flap was elevated, a 1.5 × 1.5-cm AlloDerm® section was grafted to the inner surface of the elevated C-V flap; the grafted area was then folded into a cylindrical shape. Nipple projection was measured with an electronic caliper at the time of surgery and at 3 weeks and 3 months postoperatively. Results Immediately postoperatively, nipple projection ranged from 5 to 11 mm (mean, 8.1 mm). The mean maintenance of nipple projection at 3 months postoperatively was 73.14% ± 16.39% (82% and 58% in the breast implant and autologous tissue flap groups, respectively), as compared with the immediate postoperative measurements. Conclusions Our results demonstrated a good maintenance rate of ADM retention. Our method is easy to implement and focuses on the maximal retention of ADM to provide long-term projection of the reconstructed nipple.

Keywords

• acellular dermis
• nipples
• reconstructive surgical procedures