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Published in: European Journal of Plastic Surgery 11/2013

01-11-2013 | Original Paper

Triple-V flap: nipple reconstruction using a modified C-V flap technique for long-lasting improvement of projection

Authors: Francesco Klinger, Fabio Caviggioli, Valeriano Vinci, Davide Forcellini, Luca Maione, Andrea Lisa, Marco Klinger

Published in: European Journal of Plastic Surgery | Issue 11/2013

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Abstract

Background

Reconstruction of the nipple–areola complex is the last procedure in breast reconstruction after mastectomy. Various techniques have been described, but the creation of a long-lasting projection represents a challenge in plastic surgery causing frequent nipple projection loss.

Methods

From December 2008 and September 2010, we performed 43 nipple reconstructions using our new technique named “triple-V flap.” This procedure is similar to C-V flap but uses a further V limb area that is de-epithelialized and provides significant support to the new nipple. Clinical assessment was performed with a caliper measuring nipple projection at 1, 6, and 12 months after the surgical procedure.

Results

We evaluated the triple-V nipple reconstruction technique in 43 patients. Reconstructed nipple projection ranged between 3.3 and 6.4 mm (mean 4.8 mm). Mean decrease in nipple projection was 0.2 mm at 1 month, 1.4 mm at 6 months, and 1.6 mm at 1 year. After 1 year, mean nipple projection decrease was 34 %.

Conclusions

Our triple-V technique allows the maintenance of long-lasting projection of the reconstructed nipple at 12 months after surgery. Ease and speed of execution made our technique usable in all patients who need to complete the breast reconstruction process.
Level of Evidence: Level IV, therapeutic study.
Literature
1.
go back to reference Adams WM (1949) Labial transplant for correction of loss of the nipple. Plast Reconstr Surg 4(3):295–298CrossRef Adams WM (1949) Labial transplant for correction of loss of the nipple. Plast Reconstr Surg 4(3):295–298CrossRef
2.
go back to reference Brent B, Bostwick J (1977) Nipple-areola reconstruction with auricular tissues. Plast Reconstr Surg 60(3):353–361PubMed Brent B, Bostwick J (1977) Nipple-areola reconstruction with auricular tissues. Plast Reconstr Surg 60(3):353–361PubMed
3.
go back to reference Lemperle G, Spitalny H (1980) Reconstruction of the nipple and areola after radical mastectomy. Acta Chir Belg 79(2):155–157PubMed Lemperle G, Spitalny H (1980) Reconstruction of the nipple and areola after radical mastectomy. Acta Chir Belg 79(2):155–157PubMed
5.
go back to reference Hiroki M, Yuiro H (2008) Modified C-V flap in nipple reconstruction. J Plast Reconstr Aesthet Surg 61(9):1109–1110CrossRef Hiroki M, Yuiro H (2008) Modified C-V flap in nipple reconstruction. J Plast Reconstr Aesthet Surg 61(9):1109–1110CrossRef
6.
go back to reference Muruci A, Dantas JJ, Noguerira LR (1978) Reconstruction of the nipple-areola complex. Plast Reconstr Surg 61(4):558–560PubMedCrossRef Muruci A, Dantas JJ, Noguerira LR (1978) Reconstruction of the nipple-areola complex. Plast Reconstr Surg 61(4):558–560PubMedCrossRef
7.
go back to reference Serafin D, Georgiade N (1982) Nipple-areola reconstruction after mastectomy. Ann Plast Surg 8(1):29–34PubMedCrossRef Serafin D, Georgiade N (1982) Nipple-areola reconstruction after mastectomy. Ann Plast Surg 8(1):29–34PubMedCrossRef
8.
go back to reference Tanabe HY, Tai Y, Kiyokawa K, Yamauchi T (1997) Nipple-areola reconstruction with a dermal-fat flap and rolled auricular cartilage. Plast Reconstr Surg 100(2):431–438PubMedCrossRef Tanabe HY, Tai Y, Kiyokawa K, Yamauchi T (1997) Nipple-areola reconstruction with a dermal-fat flap and rolled auricular cartilage. Plast Reconstr Surg 100(2):431–438PubMedCrossRef
9.
go back to reference Vecchione TR (1986) Reconstruction and/or salvage of nipple projection. Plast Reconstr Surg 78(5):679–683PubMedCrossRef Vecchione TR (1986) Reconstruction and/or salvage of nipple projection. Plast Reconstr Surg 78(5):679–683PubMedCrossRef
10.
go back to reference Bernard RW, Beran SJ (2003) Autologous fat graft in nipple reconstruction. Plast Reconstr Surg 112(4):964–968PubMedCrossRef Bernard RW, Beran SJ (2003) Autologous fat graft in nipple reconstruction. Plast Reconstr Surg 112(4):964–968PubMedCrossRef
11.
go back to reference Caviggioli F, Villani F, Forcellini D, Vinci V, Klinger F (2010) Nipple resuscitation by lipostructure in burn sequelae and scar retraction. Plast Reconstr Surg 125(4):174e–176ePubMedCrossRef Caviggioli F, Villani F, Forcellini D, Vinci V, Klinger F (2010) Nipple resuscitation by lipostructure in burn sequelae and scar retraction. Plast Reconstr Surg 125(4):174e–176ePubMedCrossRef
12.
go back to reference Brackley PT, Iqbal A (2009) Enhancing your C-V flap nipple reconstruction. J Plast Reconstr Aesthet Surg 62(1):128–130PubMedCrossRef Brackley PT, Iqbal A (2009) Enhancing your C-V flap nipple reconstruction. J Plast Reconstr Aesthet Surg 62(1):128–130PubMedCrossRef
13.
go back to reference Farhadi J, Maksvytyte GK, Schaefer DJ, Pierer G, Scheufler O (2006) Reconstruction of the nipple-areola complex: an update. J Plast Reconstr Aesthet Surg 59(1):40–53PubMedCrossRef Farhadi J, Maksvytyte GK, Schaefer DJ, Pierer G, Scheufler O (2006) Reconstruction of the nipple-areola complex: an update. J Plast Reconstr Aesthet Surg 59(1):40–53PubMedCrossRef
14.
go back to reference Caviggioli F, Ventura D, Andretto Amodeo C, Klinger F (2008) Inverted nipple: use of an effective and personalized splint after surgical correction with Pitanguy's technique to avoid relapse of the inversion in 28 cases. Plast Reconstr Surg 121(3):139e–140ePubMedCrossRef Caviggioli F, Ventura D, Andretto Amodeo C, Klinger F (2008) Inverted nipple: use of an effective and personalized splint after surgical correction with Pitanguy's technique to avoid relapse of the inversion in 28 cases. Plast Reconstr Surg 121(3):139e–140ePubMedCrossRef
15.
go back to reference Barton FE (1982) Latissimus dermal-epidermal nipple reconstruction. Plast Reconstr Surg 70(2):234–237PubMedCrossRef Barton FE (1982) Latissimus dermal-epidermal nipple reconstruction. Plast Reconstr Surg 70(2):234–237PubMedCrossRef
16.
go back to reference Brent B (1979) Nipple-areola reconstruction following mastectomy: an alternative to the use of labial and contralateral nipple areolar tissues. Clin Plast Surg 6(1):85–92PubMed Brent B (1979) Nipple-areola reconstruction following mastectomy: an alternative to the use of labial and contralateral nipple areolar tissues. Clin Plast Surg 6(1):85–92PubMed
17.
go back to reference Gruber RP (1979) Nipple-areola reconstruction: a review of techniques. Clin Plast Surg 6(1):71–83PubMed Gruber RP (1979) Nipple-areola reconstruction: a review of techniques. Clin Plast Surg 6(1):71–83PubMed
18.
go back to reference Little JW 3rd, Munasifi T, McCulloch DT (1983) One stage reconstruction of a projecting nipple: the quadrapod flap. Plast Reconstr Surg 71(1):126–133PubMed Little JW 3rd, Munasifi T, McCulloch DT (1983) One stage reconstruction of a projecting nipple: the quadrapod flap. Plast Reconstr Surg 71(1):126–133PubMed
Metadata
Title
Triple-V flap: nipple reconstruction using a modified C-V flap technique for long-lasting improvement of projection
Authors
Francesco Klinger
Fabio Caviggioli
Valeriano Vinci
Davide Forcellini
Luca Maione
Andrea Lisa
Marco Klinger
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Plastic Surgery / Issue 11/2013
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-013-0878-4

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