Arch Plast Surg.  2017 Sep;44(5):449-452. 10.5999/aps.2017.44.5.449.

Two-Blade Guillotine Technique for Nipple Graft Harvest

• Wong AW
• Chew KY
• Tan BK

• KMID: 2392320
• DOI: http://doi.org/10.5999/aps.2017.44.5.449

Abstract

The nipple-sharing technique for nipple reconstruction offers excellent tissue matching. The method used for nipple graft harvesting determines the quality of the graft and hence, the success of nipple sharing. Here, we described a guillotine technique wherein the nipple is first transfixed with 2 straight needles to stabilise it. Two No. 11 blades are then inserted in the center and simultaneously swept outwards to amputate the distal portion of the nipple. This technique provides good control, resulting in a very evenly cut base. The recipient bed is deepithelialized thinly, and the nipple graft is inset with interrupted 8-0 nylon sutures under magnification. Being a composite graft, it is protected with splint dressings for 6 weeks, and the dressing is regularly changed by the surgeon. The height of the nipple grafts ranges from 4 to 8 mm. This technique was performed in 9 patients with an average follow-up of 2.9 years (range, 1-4.5 years). Apposition between the nipple graft and its bed is crucial for the success of this technique. When correctly applied, we observed rapid revascularization of the graft.

Keyword

Nipples; Breast neoplasm; Free flaps; Autografts

MeSH Terms

Autografts
Bandages
Breast Neoplasms
Follow-Up Studies
Free Tissue Flaps
Humans
Methods
Needles
Nipples*
Nylons
Splints
Sutures
Transplants*
Nylons