[Immediate breast and nipple reconstruction with the latissimus dorsi myocutaneous flap].

OBJECTIVE: To investigate the feasibility of immediate breast and nipple-areola reconstruction after skin-sparing mastectomy.

METHODS: 24 patients who received skin-sparing mastectomy underwent immediate breast reconstruction with or without breast implants. The nipple-areola complex is also reconstructed with the skin paddle of the latissimus dorsi flap in one stage.

RESULTS: All the latissimus dorsi myocutaneous flaps survived completely. Partial necrosis happened in two reconstructed nipples which healed after dress changing. The follow-up period ranged from 6 to 12 months. 3 patients presented with capsular contracture (Baker I), with no necessary of surgical revision. The retraction rate of reconstructed nipples projection is 35.4% at 6 months postoperatively and 38.6% at 12 months postoperatively. 91.7% of patients were satisfied or very satisfied with the breast shape, while 83.3% were satisfied or very satisfied with the breast volume. All the patients considered the reconstructed nipple very good, while 91.6% were satisfied with the nipple projection. 91.7% considered immediate nipple reconstruction to be very important, and 8.3% considered it to be important. 66.7% considered the new breast could replace the breast they had lost, and 8.3% considered that it could not.

CONCLUSION: For skin-sparing mastectomy, immediate breast and nipple reconstruction can achieve good aesthetic results.