Introduction: Breast cancer cases, mastectomy and following reconstruction procedures are growing in numbers. Despite being lifesaving, mastectomies have a destructive psychological impact on the patients. On the other hand, breast reconstruction improves psychological damages within the same population. Various techniques for nipple reconstruction were described in literature. Trillium flap is an innovative technique to reconstruct neo-nipple with several advantages that make it superior to other popular flaps. Objectives: To come up with an innovative design for reconstructing a neo-nipple post mastectomy, that is superior to other popular flaps. Results: The Trillium flap design has less visible and easily camouflaged scars, is geometry-based, specific, well-detailed and flexible to produce a tailored nipple with any desired height and diameter and ensures the flaps good vascularity and the neo-nipple projection sustainability. Conclusion: Trillium flap is an innovative technique to reconstruct neo-nipple with several advantages that make it superior to other popular flaps. The results shown in the study are for experimental procedures done on human tissue samples of excised flaps from abdominoplasties and brachioplasties. Further application on actual cases is needed with monitoring of neo-nipple projection sustainability on the long term.
References
[1]
Mariotto, A.B., Etzioni, R., Hurlbert, M., Penberthy, L. and Mayer, M. (2017) Estimation of the Number of Women Living with Metastatic Breast Cancer in the United States. Cancer Epidemiology, Biomarkers & Prevention, 26, 809-815. https://doi.org/10.1158/1055-9965.EPI-16-0889
[2]
American College of Surgeons Commission on Cancer (2019) National Cancer Database, 2016 Data Submission. American College of Surgeons Commission on Cancer, Chicago, IL.
[3]
Zhao, R., Qiao, Q., Yue, Y., et al. (2003) The Psychological Impact of Mastectomy on Women with Breast Cancer. Chinese Journal of Plastic Surgery, 19, 294-296.
[4]
Nozawa, K., Ichimura, M., Oshima, A., et al. (2015) The Present State and Perception of Young Women with Breast Cancer towards Breast Reconstructive Surgery. International Journal of Clinical Oncology, 20, 324-331. https://doi.org/10.1007/s10147-014-0716-0
[5]
Gopie, J.P., Mureau, M.A., Seynaeve, C., et al. (2013) Body Image Issues after Bilateral Prophylactic Mastectomy with Breast Reconstruction in Healthy Women at Risk for Hereditary Breast Cancer. Familial Cancer, 12, 479-487. https://doi.org/10.1007/s10689-012-9588-5
[6]
Fallbjörk, U., Rasmussen, B.H., Karlsson, S. and Salander, P. (2013) Aspects of Body Image after Mastectomy Due to Breast Cancer—A Two-Year Follow-up Study. European Journal of Oncology Nursing, 17, 340-345. https://doi.org/10.1016/j.ejon.2012.09.002
[7]
Schover, L.R. (1994) Sexuality and Body Image in Younger Women with Breast Cancer. Journal of the National Cancer Institute Monographs, 16, 177-182.
[8]
Chen, W., Lv, X., Xu, X., Gao, X. and Wang, B. (2018) Meta-Analysis for Psychological Impact of Breast Reconstruction in Patients with Breast Cancer. Breast Cancer, 25, 464-469. https://doi.org/10.1007/s12282-018-0846-8
[9]
Rowland, J.H., Holland, J.C., Chaglassian, T. and Kinne, D. (1993) Psychological Response to Breast Reconstruction. Expectations for and Impact on Postmastectomy Functioning. Psychosomatics, 34, 241-250. https://doi.org/10.1016/S0033-3182(93)71886-1
[10]
Shiffman, M.A. (2018) History of Nipple-Areolar Complex Reconstruction. In: Nipple-Areolar Complex Reconstruction, Springer, Cham, 10-11. https://doi.org/10.1007/978-3-319-60925-6
[11]
Davis, G.B., Miller, T. and Lee, G. (2018) Nipple Reconstruction: Risk Factors and Complications. In: Shiffman, M., Ed., Nipple-Areolar Complex Reconstruction, Springer, Cham, 624-625.
[12]
Sanuki, J., Fukuma, E. and Uchida, Y. (2009) Morphologic Study of Nipple-Areola Complex in 600 Breasts. Aesthetic Plastic Surgery, 33, 295-297. https://doi.org/10.1007/s00266-008-9194-y
[13]
Hauben, D.J., Adler, N., Silfen, R. and Regev, D. (2003) Breast-Areola-Nipple Proportion. Aesthetic Plastic Surgery, 50, 510-513. https://doi.org/10.1097/01.SAP.0000044145.34573.F0
[14]
Lewin, R., Amoroso, M., Plate, N., Clara, C. and Selvaggi, G. (2016) The Aesthetically Ideal Position of the Nipple-Areola Complexon the Breast. Aesthetic Plastic Surgery, 40, 724-732. https://doi.org/10.1007/s00266-016-0684-z
[15]
Ramsey, D. (2007) Trillium grandiflorum. Self-Photographed. Photo Taken at the Mt. Cuba Center Where It Was Identified. https://commons.wikimedia.org/wiki/File:White_Trillium_Trillium_grandiflorum_Flower_2613px.jpg
[16]
Huang, W. (2003) A New Method for Correction of Inverted Nipple with Three Periductal Dermofibrous Flaps. Aesthetic Plastic Surgery, 27, 301-304. https://doi.org/10.1007/s00266-003-3047-5
[17]
Hsiao, S., Huang, W., Yu, C., Tsai, Y. and Tung, K. (2008) Refinement of Three Periductal Dermofibrous Flaps Method for Correction of Inverted Nipples.
[18]
Kim, J.T. and Singh, J. (2018) Correction of Inverted Nipples with Twisting and Locking Principle. In: Shiffman, M., Ed., Nipple-Areolar Complex Reconstruction, Springer, Cham, 315-329. https://doi.org/10.1007/978-3-319-60925-6_38
[19]
Berson, M.I. (1946) Construction of Pseudoareola. Surgery, 20, 808.
[20]
Sisti, A., Tassinari, J., Cuomo, R., Brandi, C., Nisi, G., Grimaldi, L. and D’Aniello, C. (2018) Nipple-Areola Complex Reconstruction. In: Shiffman, M., Ed., Nipple-Areolar Complex Reconstruction, Springer, Cham, 359-368. https://doi.org/10.1007/978-3-319-60925-6_43
