E-flap nipple reconstruction in amputation mammaplasty

Background: Although widely used in women who have gigantomastia, free nipple graft breast reduction has several disadvantages with respect to the nipple-areola graft. In this report, we present the use of a nipple reconstruction method instead of free nipple grafting. Method Free nipple reduction mammaplasty is performed according to the Wise pattern. The nipple is removed from the areola graft. Nipple reconstruction is done at the most proximal and projected part of the reduced breast, which corresponds to the future nipple site. Afterward, the reconstructed nipple is encircled with the areola graft. Results: A total of 18 patients underwent breast reduction with nipple reconstruction and areola grafting between April 2007 and March 2010. The mean follow-up period was 8 months. With the proposed nipple reconstruction technique, the mean projections of the nipple at the end of the operation and at 6 months were 1.2 and 0.9 cm, respectively. Conclusion: The technique of using nipple reconstruction in amputation mammaplasty avoids the problems related to the nipple graft such as loss of projection, loss of sensation, or even total or partial loss of the nipple. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2012.