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De-epithelialized dermal flap for nipple reconstruction: A modified star flapopen access

Authors
Lee, Su HyunKim, Deok WooYou, Hi JinJung, Jae A.Hwang, Na HyunYou, Jae PilYoon, Eul Sik
Issue Date
Jul-2019
Publisher
Korean Society of Plastic and Reconstructive Surgeons
Keywords
Nipples; Surgical flaps; Mammoplasty
Citation
Archives of Plastic Surgery, v.46, no.4, pp.324 - 329
Indexed
SCOPUS
KCI
Journal Title
Archives of Plastic Surgery
Volume
46
Number
4
Start Page
324
End Page
329
URI
https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/147416
DOI
10.5999/aps.2018.01011
ISSN
2234-6163
Abstract
Background Multiple approaches for nipple reconstruction exist, and none is considered superior to all others. The star flap is one of the most popular methods for nipple reconstruction, but gradual height loss is a major concern. We present a new modification of the star flap that incorporates a de-epithelialized dermal flap, along with the associated surgical results. Methods We reviewed the medical records of patients who underwent nipple reconstruction using the modified star flap method. The design was different from the conventional star flap in that the lateral wings were changed into a trapezoidal shape and de-epithelialized dermal flaps were added. The patients were followed up at 2, 4, 6, and 12 months postoperatively, and nipple height was measured. The postoperative nipple height achieved using the modified method was compared with that obtained using the traditional method. Results From February 2013 to June 2017, 32 patients received surgery using the modified star flap, and 18 patients who underwent nipple reconstruction before 2013 comprised the conventional method group. All patients had undergone breast reconstruction with an abdominal tissue-based flap. The mean follow-up period was 14.4 months in the modified method group and 17.3 months in the conventional method group. The mean maintenance of projection at 12 months postoperatively was 56.28%±18.58% in the modified method group, and 44.23%±14.15% in the conventional method group. This difference was statistically significant (P<0.05). Conclusions The modified method using a de-epithelialized dermal flap provides reliable maintenance of projection in patients who have undergone abdominal tissue-based breast reconstruction.
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COLLEGE OF MEDICINE (DEPARTMENT OF PLASTIC AND RECONSTRUCTIVE SURGERY)
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