COMPARATIVE STUDY OF NIPPLE PROJECTION ACCORDING TO THE RECONSTRUCTIVE METHOD BETWEEN LOCAL CHEST FLAP AND NIPPLE SHARING

Kim, Yang Woo

Abstract

The nipple-areola is the integral part of the breast. The purpose of nipple reconstruction is the creation of similar nipple like the opposite one in aspects of diameter, projection, colon and texture. To achieve these goals there have been many methods in the nipple reconstruction. Among these methods local chest flap is the popular one in nipple reconstruction. And the second method is nipple sharing and composite grafting of the opposite nipple. We compared the late result of the difference of nipple projection between two methods in 31 nipple reconstruction cases. The height of the nipple reconstructed by local flap was 8.3mm at the postoperative 2 weeks. But late result of it was 2.2mm, so 73.5% loss of nipple height was observed at that time. It was significantly lowered than one by nipple sharing method. Then most of them needed secondary surgery such as tattooing, additional augmented graft. However the height of the nipple reconstructed by nipple sharing was 6.9mm at the postoperative 2 weeks. Late result of it was 6.3mm, then only 8.7% loss of nipple projection showed. There was a significant loss of nipple protruding in local flap method comparing with nipple sharing method. The color matching and texture were more natural and similar to the opposite nipple in nipple sharing method than local chest flap ones. However nipple sharing method has many limitations in small or flat nipples. But these limitations can be gotten over by selecting the proper sharing method and including surround areolar tissue. We concluded that the projection of the nipple reconstructed by sharing method was significantly well maintained and more effective than one reconstructed by local chest flap. And the late result of local chest flap method was poor in the projection of nipple.