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Nipple Reconstruction Using the Modified Top Hat Flap With Banked Costal Cartilage Graft

2007; Lippincott Williams & Wilkins; Volume: 59; Issue: 6 Linguagem: Inglês

10.1097/sap.0b013e318048573c

1536-3708

Ming‐Huei Cheng, Eduardo D. Rodriguez, James M. Smartt, Alexander Cárdenas‐Mejía,

Reconstructive Facial Surgery Techniques

In Brief The long-term projection of nipple reconstruction is a challenge. Fifty-eight consecutive female patients underwent 58 nipple reconstructions with modified top hat flap with cartilage graft following breast reconstruction in 54 autologous tissues and 4 implants, respectively. The average neonipple size was 11.5 mm initially and 8.5 mm at a mean follow-up of 44.9 months (range, 24–65 months), with a mean decrease in projection of 26.1%. Thirty-three patients achieved an excellent result, 20 patients a good result, 3 patients a fair result, and 2 patients a poor result, respectively. The complication rate was 12.1% (7 of 58 cases), and there was no statistically significant difference between the immediate and delayed groups; the revision rate was 8.6% (5 of 58 cases). The modified top hat flap with banked costal cartilage graft provides a sustainable solution to the gradual loss of nipple projection, with few complications. Fifty-eight consecutive modified top-hat nipple reconstructions with a centrally bolstering cartilage graft showed a mean projection loss of 26.1% over a mean follow-up of 45 months. The complication rate was 12.1% and the revision rate 8.6%.