Modified C-H flap for simultaneous nipple reconstruction during autologous breast reconstruction: Surgical tips for safety and cosmesis

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Abstract

Background: Reconstruction of the nipple-areolar complex is the final stage of breast reconstruction. Nipple reconstruction is usually performed several months after breast reconstruction, because simultaneous reconstruction is thought to be risky. Here, we introduce our experiences of 1-stage procedures with immediate reconstruction of the nipple-areolar complex during autologous breast reconstruction. Methods: Between 2008 and 2015, 51 mastectomy patients underwent 1-stage breast and nipple reconstruction. All cases were reconstructed immediately with autologous tissue for the breast mound. The patients were divided into 2 groups according to the method of nipple-areolar complex reconstruction. In group A, 23 cases were reconstructed with a classical C-H flap, also known as the Hammond flap. In group B, 28 cases were reconstructed with a modified C-H flap, which is the evolved form of the classical Hammond flap. The nipple-areolar complex was evaluated preoperatively, immediately postoperatively, and 1 year postoperatively. Postoperative complications were also evaluated. Results: The mean projection of the reconstructed nipple decreased by approximately 50% in group A and 38% in group B during the postoperative 1 year. However, the reconstructed nipple width and areolar diameter did not show a significant change in either group. Group A showed 26% of complication rate and 17% of revision rate, whereas group B showed 11% of complication rate and 4% of revision rate. However, no major complications such as complete necrosis of the reconstructed nipple, were observed in any patients. Conclusion: The modified technique group showed superior results in terms of safety and cosmesis. With our modified C-H flap method, simultaneous breast and nipple reconstruction is safe and has satisfactory results. Abbreviations: LD = latissimus dorsi, TRAM = transverse rectus abdominis musculocutaneous.

Original languageEnglish
Article numbere12460
JournalMedicine (United States)
Volume97
Issue number38
DOIs
StatePublished - 2018 Jan 1

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Nipples
Mammaplasty
Safety
Rectus Abdominis
Superficial Back Muscles
Mastectomy
Breast
Necrosis

Keywords

  • Breast reconstruction
  • C-H flap
  • Nipple reconstruction
  • One stage reconstruction

Cite this

@article{61b42df6ec504fe3a9f009292c406c9f,
title = "Modified C-H flap for simultaneous nipple reconstruction during autologous breast reconstruction: Surgical tips for safety and cosmesis",
abstract = "Background: Reconstruction of the nipple-areolar complex is the final stage of breast reconstruction. Nipple reconstruction is usually performed several months after breast reconstruction, because simultaneous reconstruction is thought to be risky. Here, we introduce our experiences of 1-stage procedures with immediate reconstruction of the nipple-areolar complex during autologous breast reconstruction. Methods: Between 2008 and 2015, 51 mastectomy patients underwent 1-stage breast and nipple reconstruction. All cases were reconstructed immediately with autologous tissue for the breast mound. The patients were divided into 2 groups according to the method of nipple-areolar complex reconstruction. In group A, 23 cases were reconstructed with a classical C-H flap, also known as the Hammond flap. In group B, 28 cases were reconstructed with a modified C-H flap, which is the evolved form of the classical Hammond flap. The nipple-areolar complex was evaluated preoperatively, immediately postoperatively, and 1 year postoperatively. Postoperative complications were also evaluated. Results: The mean projection of the reconstructed nipple decreased by approximately 50{\%} in group A and 38{\%} in group B during the postoperative 1 year. However, the reconstructed nipple width and areolar diameter did not show a significant change in either group. Group A showed 26{\%} of complication rate and 17{\%} of revision rate, whereas group B showed 11{\%} of complication rate and 4{\%} of revision rate. However, no major complications such as complete necrosis of the reconstructed nipple, were observed in any patients. Conclusion: The modified technique group showed superior results in terms of safety and cosmesis. With our modified C-H flap method, simultaneous breast and nipple reconstruction is safe and has satisfactory results. Abbreviations: LD = latissimus dorsi, TRAM = transverse rectus abdominis musculocutaneous.",
keywords = "Breast reconstruction, C-H flap, Nipple reconstruction, One stage reconstruction",
author = "Yoon, {Jung Soo} and Chang, {Jung Woo} and Ahn, {Hee Chang} and Chung, {Min Sung}",
year = "2018",
month = "1",
day = "1",
doi = "10.1097/MD.0000000000012460",
language = "English",
volume = "97",
journal = "Medicine",
issn = "0025-7974",
number = "38",

}

TY - JOUR

T1 - Modified C-H flap for simultaneous nipple reconstruction during autologous breast reconstruction

T2 - Surgical tips for safety and cosmesis

AU - Yoon, Jung Soo

AU - Chang, Jung Woo

AU - Ahn, Hee Chang

AU - Chung, Min Sung

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Reconstruction of the nipple-areolar complex is the final stage of breast reconstruction. Nipple reconstruction is usually performed several months after breast reconstruction, because simultaneous reconstruction is thought to be risky. Here, we introduce our experiences of 1-stage procedures with immediate reconstruction of the nipple-areolar complex during autologous breast reconstruction. Methods: Between 2008 and 2015, 51 mastectomy patients underwent 1-stage breast and nipple reconstruction. All cases were reconstructed immediately with autologous tissue for the breast mound. The patients were divided into 2 groups according to the method of nipple-areolar complex reconstruction. In group A, 23 cases were reconstructed with a classical C-H flap, also known as the Hammond flap. In group B, 28 cases were reconstructed with a modified C-H flap, which is the evolved form of the classical Hammond flap. The nipple-areolar complex was evaluated preoperatively, immediately postoperatively, and 1 year postoperatively. Postoperative complications were also evaluated. Results: The mean projection of the reconstructed nipple decreased by approximately 50% in group A and 38% in group B during the postoperative 1 year. However, the reconstructed nipple width and areolar diameter did not show a significant change in either group. Group A showed 26% of complication rate and 17% of revision rate, whereas group B showed 11% of complication rate and 4% of revision rate. However, no major complications such as complete necrosis of the reconstructed nipple, were observed in any patients. Conclusion: The modified technique group showed superior results in terms of safety and cosmesis. With our modified C-H flap method, simultaneous breast and nipple reconstruction is safe and has satisfactory results. Abbreviations: LD = latissimus dorsi, TRAM = transverse rectus abdominis musculocutaneous.

AB - Background: Reconstruction of the nipple-areolar complex is the final stage of breast reconstruction. Nipple reconstruction is usually performed several months after breast reconstruction, because simultaneous reconstruction is thought to be risky. Here, we introduce our experiences of 1-stage procedures with immediate reconstruction of the nipple-areolar complex during autologous breast reconstruction. Methods: Between 2008 and 2015, 51 mastectomy patients underwent 1-stage breast and nipple reconstruction. All cases were reconstructed immediately with autologous tissue for the breast mound. The patients were divided into 2 groups according to the method of nipple-areolar complex reconstruction. In group A, 23 cases were reconstructed with a classical C-H flap, also known as the Hammond flap. In group B, 28 cases were reconstructed with a modified C-H flap, which is the evolved form of the classical Hammond flap. The nipple-areolar complex was evaluated preoperatively, immediately postoperatively, and 1 year postoperatively. Postoperative complications were also evaluated. Results: The mean projection of the reconstructed nipple decreased by approximately 50% in group A and 38% in group B during the postoperative 1 year. However, the reconstructed nipple width and areolar diameter did not show a significant change in either group. Group A showed 26% of complication rate and 17% of revision rate, whereas group B showed 11% of complication rate and 4% of revision rate. However, no major complications such as complete necrosis of the reconstructed nipple, were observed in any patients. Conclusion: The modified technique group showed superior results in terms of safety and cosmesis. With our modified C-H flap method, simultaneous breast and nipple reconstruction is safe and has satisfactory results. Abbreviations: LD = latissimus dorsi, TRAM = transverse rectus abdominis musculocutaneous.

KW - Breast reconstruction

KW - C-H flap

KW - Nipple reconstruction

KW - One stage reconstruction

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U2 - 10.1097/MD.0000000000012460

DO - 10.1097/MD.0000000000012460

M3 - Article

C2 - 30235735

AN - SCOPUS:85054454522

VL - 97

JO - Medicine

JF - Medicine

SN - 0025-7974

IS - 38

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ER -