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Long V-Y advancement technique for large nipple reconstruction in Asian women

Archives of Plastic Surgery 2021년 48권 1호 p.44 ~ 48
장남, 김준규, 신현우, 석상우,
소속 상세정보
장남 ( Jang Nam ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Plastic and Reconstructive Surgery
김준규 ( Kim June-Kyu ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Plastic and Reconstructive Surgery
신현우 ( Shin Hyun-Woo ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Plastic and Reconstructive Surgery
석상우 ( Suk Sang-Woo ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Plastic and Reconstructive Surgery

Abstract


Previously reported nipple-areolar complex reconstruction (NAR) methods involve multiple incisions and wide skin redraping, which increase retraction forces and heighten the risk of nipple-areolar complex (NAC) flattening. We introduce a NAR method using the long V-Y advancement technique that can overcome these disadvantages. A V-shaped flap is designed with the width of the flap base 4?5 mm larger than the diameter of the normal nipple. The flap length is designed to be at least 2.5 times its width. Dissection is performed to the top of the artificial dermal matrix or muscle layer. The nipple is constructed with the same projection as the contralateral side by folding the elevated flap. The tip of the elevated flap is apposed in the middle of the donor defect to minimize the deformity during donor site closure. A 3-point skin suture is applied to the upper third of the folded flap to mold its shape. Using this long V-Y advancement technique, we successfully decreased skin tension in NAC flaps and improved the maintenance of reconstructed nipple projection. The long V-Y advancement technique provides an easy, simple NAR method, effectively maintaining longer nipple projections and reducing breast deformities, especially in Asian women with relatively large nipples.

키워드

Breast; Nipples; Mastectomy; Mammaplasty

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