Nipple-Areola Reconstruction

Abstract

Nipple-areola reconstruction is the final step of breast reconstruction. ‘Shape' and ‘color' are important to make the breast mound look natural. The nipple and areola are mostly composed of epithelium. In addition, smooth muscle changes of the shape. Local flap nipple reconstruction causes a decrease in projection because of the small amount of epithelium and no smooth muscle. In general, Asian women have a slightly larger nipple and smaller areola. Therefore, the flap scar sometimes extends beyond the reconstructed areola. We reconstructed the ‘shape' with a skate flap, and then changed to a C-V flap. Subsequently, a modified C-V flap and wheel steeling flap with or without costal cartilage were developed for long-term projection and to shorten the scar length. On the other hand, tattoos are mainly used for ‘color'. This paper reviews our methods for nipple-areola reconstruction.