J Korean Soc Plast Reconstr Surg Search

CLOSE


Journal of the Korean Society of Plastic and Reconstructive Surgeons 2005;32(1):76-84.
Published online January 1, 2005.
Immediate Nipple Reconstruction in Breast Reconstruction with TRAM Free Flap.
Jeong Tae Kim, Chang Yeon Kim, Ji Hun Cha, Weon Jung Hwang
Department of Plastic & Reconstructive Surgery, College of Medicine, Hanyang University, Korea. jtkim@hanyang.ac.kr
Abstract
Immediate breast reconstruction in breast cancer patients is universalized and now with a wide variety of methods to choose from, we can select a breast reconstruction method according to the patient's condition. Among these methods, immediate breast reconstruction with TRAM free flap is the most commonly used. Nipple reconstruction is usually performed as a secondary procedure, reconstructed. Nipple is reconstructed with contralateral nipple composite graft or with local flap. Areola is reconstructed with skin graft and tattooing. Therefore, to reconstruct complete breast, two or more staged operations are needed and are troublesome to both the surgeon and the patient. If we could reconstruct breast mound and nipple at same time, we would reduce the operative stages and heighten the patient's satisfaction. The author performed delayed or immediate breast reconstruction with TRAM free flap and nipple reconstruction at the same time. If the TRAM flap was to situate in the whole of the breast or at the center of the breast mound, nipple was reconstructed with a local flap from the TRAM flap. If the TRAM flap was not situated in center of breast mound, nipple was reconstructed with a local flap from remnant breast skin. Immediate nipple reconstructions in breast reconstruction consisted total of 22 cases. Among these, delayed breast reconstruction were 5 cases and immediate breast reconstruction were 17 cases. According to patient's condition and mastectomy method, nipple reconstruction method was selected; nipple reconstruction with contralateral nipple composite graft(3 cases); nipple reconstruction with remnant breast skin(6 cases); nipple reconstruction from flap margin(10 cases); nipple reconstruction with prefabricated nipple on flap(3 cases). Malposition of the reconstructed nipple was the most common and serious complication(6 cases). The other complications were atrophy of the nipple(1 case), and necrosis(1 case). Reconstruction of the breast and nipple at the same time can reduce the need of a secondary operation and use remnant skin or redundant flap tissue maximally. On the other hand, it must be considered that position and shape of nipple could be deformed, because the nipple reconstruction is performed before the shape of reconstructed breast settles completely. Prudent attention is needed, because the danger of complication is higher than delayed nipple reconstruction.
Keywords: Immediate nipple reconstruction
TOOLS
Share :
Facebook Twitter Linked In Google+ Line it
METRICS Graph View
  • 51 View
  • 0 Download

Latissimus Dorsi Flap for Secondary Breast Reconstruction after Partial TRAM Flap Loss.2009 January;36(1)

Nipple Reconstruction using the C-V Flap Technique after Breast Reconstruction with the Only Breast Expander.2009 July;36(4)

Timing and Causes of Vascular Compromise in Breast Reconstruction with Free TRAM Flap.2009 September;36(5)

Dural Reconstruction in Refractory Cranial Infection using Omental Free Flap.2009 September;36(5)

Secondary Breast Reconstruction.2009 November;36(6)



ABOUT
ARTICLE CATEGORY

Browse all articles >

BROWSE ARTICLES
AUTHOR INFORMATION
Editorial Office
101-2003, Lotte Castle President, 109, Mapodaero, Mapo-gu, Seoul 04146, Korea
Tel: +82-2-3472-8252    Fax: +82-2-3472-4254    E-mail: apsedit@gmail.com                

Copyright © 2019 by Korean Society of Plastic and Reconstructive Surgeons. All rights reserved.

Developed in M2community

Close layer
prev next