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The Double-Opposing Periareolar Flap: A Novel Concept for Nipple-Areola Reconstruction

Orloff, George M.D.

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Plastic and Reconstructive Surgery: January 2008 - Volume 121 - Issue 1 - p 342
doi: 10.1097/01.prs.0000294960.55756.84
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I read with great interest the recent article describing a new technique to reconstruct the nipple-areola entitled “The Double-Opposing Periareolar Flap: A Novel Concept for Nipple Areola Reconstruction,” by Kenneth C. Shestak, M.D., and Trung David Nguyen, M.D. (Plast. Reconstr. Surg. 119: 473, 2007).

The authors describe a technique for nipple-areola reconstruction that they originated and developed over the past 26 months. I am surprised, since I have personally been using this technique since about 1999. I learned this technique from my attending during my residency, James S. Andersen, M.D. Dr. Andersen is the chief of plastic surgery at the City of Hope Medical Center, in Duarte, California. He presented this exact same technique at the American Society of Plastic Surgeons meeting in San Diego in 2003, and the technique and design were published in the Plastic Surgery Forum.1

It is wonderful to see this technique being used successfully by others. I agree with the authors’ success using this technique. However, I do consider it important to acknowledge the origins of this technique for nipple-areola reconstruction.

George Orloff, M.D.

2701 W. Alameda Avenue, Suite 401

Burbank, Calif. 91505

[email protected]


1. Andersen, J., and Menezes, J. Purse string reconstruction of the nipple and areola. Plastic Surgery Forum 26: 49, 2003.

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