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Arrow Flap and Rib Cartilage Graft for Nipple-Areola Complex Restoration

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Abstract

Restoration of the nipple-areola complex is a key component of breast reconstruction. The authors describe a reliable method of nipple-areola reconstruction using a combination of a dermal flap shaped like an arrow and a cartilage graft which provides a strong underlying scaffold support. The authors observed that techniques using isolated soft tissue dermal flaps can eventually fail due to secondary scar contracture with loss of neo-nipple projection. The cartilage graft is harvested at the initial breast flap transfer when exposing the internal mammary vessels. The arrow flap offers additional advantages against scar contracture due to its elegant design which allows the final incisions to resemble a W-plasty configuration on the new nipple vertical limb. The combination of arrow flap and rib graft leads to a reliable nipple reconstruction.

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Author information

Authors and Affiliations

  1. Guerra Plastic Surgery Center, 8765 E. Bell Road, Suite 104, Scottsdale, AZ, 85260, USA

    Aldo B. Guerra M.D.

  2. Aesthetic Surgical Associates, 3223 8th Street, Suite 200, Metairie, LA, 70002, USA

    Stephen E. Metzinger M.D.

  3. The Center for Microsurgical Breast Reconstruction, 2525 Severn Avenue, 4th Floor, Metairie, LA, 70002, USA

    Robert J. Allen M.D.

Authors
  1. Aldo B. Guerra M.D.
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  2. Stephen E. Metzinger M.D.
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  3. Robert J. Allen M.D.
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Corresponding author

Correspondence to Aldo B. Guerra M.D. .

Editor information

Editors and Affiliations

  1. Private Practice, Tustin, California, USA

    Melvin A. Shiffman

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© 2018 Springer International Publishing AG

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Guerra, A.B., Metzinger, S.E., Allen, R.J. (2018). Arrow Flap and Rib Cartilage Graft for Nipple-Areola Complex Restoration. In: Shiffman, M. (eds) Nipple-Areolar Complex Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-319-60925-6_61

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  • DOI: https://doi.org/10.1007/978-3-319-60925-6_61

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60924-9

  • Online ISBN: 978-3-319-60925-6

  • eBook Packages: MedicineMedicine (R0)

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