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Nipple Areola Complex Reconstruction With the “Half-Dome” Technique Following Implant-Based Breast Reconstruction

Chen, Wendy, MD, MS; Fishman, Jordan E., MD, MPH; de la Cruz, Carolyn, MD

doi: 10.1097/SAP.0000000000001797
Breast Surgery

Background No single technique for nipple areola reconstruction best fits every patient and clinical scenario. Many techniques fail to provide long-term projection. One especially challenging cohort are those patients who have undergone bilateral implant-based reconstruction. We developed a modification of the C-V flap reconstruction that increases projection in the bilateral, implant-based reconstruction patient.

Methods All patients who underwent nipple areola reconstruction following implant-based breast reconstruction and who had at least a 12-month follow-up visit were identified. Nipple projection was measured and compared between the 2 groups.

Results Forty patients were identified. Twelve patients, 23 nipples, underwent the standard C-V flap reconstruction. Twenty-eight patients, 59 nipples, underwent the half-dome modification. Average nipple projection following the half-dome technique is more than twice that of the C-V flap.

Conclusions The half-dome technique provides a useful alternative modification of the C-V flap in patients with implant-based reconstruction.

From the Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA.

Received April 17, 2018, and accepted for publication, after revision November 7, 2018.

Presented at the Robert H. Ivy Pennsylvania Plastic Surgery Society meeting of 2017 and the Ohio Valley Society of Plastic Surgeons meeting of 2017.

Conflicts of interest and sources of funding: none declared.

Reprints: Carolyn de la Cruz, MD, Department of Plastic Surgery, University of Pittsburgh, 3550 Terrace St, 6B Sciafe Hall, Pittsburgh, PA 15261. E-mail:

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