Does the arrow flap associated with dermal platform really improve long-term nipple projection?

Excerpt

Reconstruction of nipple-areola complex is the final step of breast reconstruction and is often identified by patients as a hallmark of the new breast. Loss of nipple projection is the factor that patients dislike most after nipple-areola reconstruction [1]. Several surgical techniques based on local flaps have been proposed to overcome this issue. Unfortunately, all local flaps have the same drawback and are associated with a loss in projection of 50–70 % over the first three postoperative years [2‐4]. Usually, for nipple reconstruction, plastic surgeons in our research center perform the arrow flap, a modification of Thomas technique [5]. As a further modification of Thomas technique [6], Schoeller et al. recommend the use of deepithelialized base in order to obtain the stabilization of flap and less nipple projection loss [7]. In our clinical experience, we evaluate the results of a modified “arrow flap” technique with dermal platform compared to conventional “arrow flap” (Fig. 1).

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