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Nipple—Areola Reconstruction with Intradermal Tattoo and Double-Opposing Pennant Flaps

Hugo, Norman E. MD; Sultan, Mark R. MD; Hardy, Stephen P. MD
Annals of Plastic Surgery: June 1993
Original Articles: PDF Only

Reconstruction of the nipple—areolar complex is an important part of postmastectomy breast reconstruction. Intradermal tattooing is effective for creating areolar pigmentation and is simpler than skin grafting. However, a simple method for the construction of a normal nipple using local tissues remains a challenge. Several techniques achieve long-term nipple projection but at the expense of complicated flap design, multidirectional scars, and often a need for skin grafting to obtain a uniform-appearing areola. Our one-stage method of nipple—areola reconstruction uses intradermal tattooing for pigmentation and double-opposing pennant flaps for nipple reconstruction. The entire procedure is simple and fast, routinely performed in <30 minutes under local anaesthesia in the office. From September 1989 to March 1992 we performed 102 reconstructions. The method produces a realistic appearing nipple. We have had no flap necrosis.

Hugo NE, Sultan MR, Hardy SP Nipple—areola reconstruction with intradermal tattoo and double-opposing pennant flaps.

© Williams & Wilkins 1993. All Rights Reserved.