Nipple reconstruction using a star flap enhanced by scar tissue: the Regina Elena Cancer Institute experience.

BACKGROUND: We propose a new, simple, and reliable method of nipple reconstruction using a star flap and a free graft of a linear fragment of scar tissue. The harvested fragment is deepithelialized and fixed under the flap to give the reconstruction consistency and make it steady.

METHODS: The study included 218 nipple reconstructions performed between 2002 and 2008. In an attempt to estimate their satisfaction, patients were then asked to complete a 1-year postoperative questionnaire. Patients were directed to use a numerical scale of 1-10, with 1 as the worst outcome and 10 as the best possible outcome.

RESULTS: The average projection of the nipple in the immediate postoperative period was 7.08 ± 0.5 mm (mean ± standard deviation). After 1 year, the average projection of the reconstructed nipple was 6.08 ± 0.5 mm. The average diameter of the reconstructed nipple in the immediate postoperative period was 14.9 ± 3 mm. After 1 year, the average diameter of the reconstructed nipple was 14.2 ± 4 mm. The average patient satisfaction with nipple projection was 7.28, sensation of the nipple, 4.11; color of the nipple, 6.36; position of the reconstructed nipple, 7.34; and symmetry compared with the opposite nipple-areola complex, 7.97. Overall patient satisfaction was 6.61.

CONCLUSION: We maintain that the technique presented here is safe, easy to perform, and reproducible and improves the long-term projection of the reconstructed nipple.