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DOI: 10.5999/aps.2017.44.5.449
Two-Blade Guillotine Technique for Nipple Graft Harvest
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.
Publication History
Received: 20 October 2016
Accepted: 28 March 2017
Article published online:
20 April 2022
© 2017. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
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REFERENCES
- 1 Zenn MR, Garofalo JA. Unilateral nipple reconstruction with nipple sharing: time for a second look. Plast Reconstr Surg 2009; 123: 1648-53
- 2 Farhadi J, Maksvytyte GK, Schaefer DJ. et al. Reconstruction of the nipple-areola complex: an update. J Plast Reconstr Aesthet Surg 2006; 59: 40-53
- 3 Sakai S, Taneda H. New nipple-sharing technique that preserves the anatomic structure of the donor nipple for breastfeeding. Aesthetic Plast Surg 2012; 36: 308-12
- 4 Goh SC, Martin NA, Pandya AN. et al. Patient satisfaction following nipple-areolar complex reconstruction and tattooing. J Plast Reconstr Aesthet Surg 2011; 64: 360-3
- 5 Jabor MA, Shayani P, Collins Jr DR. et al. Nipple-areola reconstruction: satisfaction and clinical determinants. Plast Reconstr Surg 2002; 110: 457-63
- 6 Haslik W, Nedomansky J, Hacker S. et al. Objective and subjective evaluation of donor-site morbidity after nipple sharing for nipple areola reconstruction. J Plast Reconstr Aesthet Surg 2015; 68: 168-74
- 7 Spear SL, Schaffner AD, Jespersen MR. et al. Donor-site morbidity and patient satisfaction using a composite nipple graft for unilateral nipple reconstruction in the radiated and nonradiated breast. Plast Reconstr Surg 2011; 127: 1437-46
- 8 Edsander-Nord A, Wickman M, Hansson P. Threshold of tactile perception after nipple-sharing: a prospective study. Scand J Plast Reconstr Surg Hand Surg 2002; 36: 216-20
- 9 Dent BL, Chao JW, Eden DJ. et al. Nipple resection and reconstruction after attempted nipple-sparing mastectomy. Ann Plast Surg 2017; 78: 28-34
- 10 Adams WM. Free transplantation of the nipples and areolae. Surgery 1944; 15: 186-95
- 11 Millard Jr DR. Nipple and areola reconstruction by split-skin graft from the normal side. Plast Reconstr Surg 1972; 50: 350-3
- 12 Lee TJ, Noh HJ, Kim EK. et al. Reducing donor site morbidity when reconstructing the nipple using a composite nipple graft. Arch Plast Surg 2012; 39: 384-9