Nipple Reconstruction Using a Two-Step Purse Suture Technique

Abstract

Many options exist for the creation of a nipple-areola complex following oncologic resection or trauma. Techniques described utilize local flaps, autologous grafts, and non-autologous material. The formation of an aesthetic nipple-areola complex (NAC) with lasting projection remains a challenge with each method presenting unique advantages and disadvantages. Despite numerous techniques described, no single approach has emerged as the gold standard. This chapter outlines a two-step surgical technique in NAC reconstruction allowing for independent reconstruction of the nipple and areola complex. In our hands, this technique has produced lasting results for over 20 years. It maintains projection while creating a natural contour between the nipple, the areola complex, and the surrounding breast tissue.