Use of hyaluronic acid filler for enhancement of nipple projection following breast reconstruction: An easy and effective technique

Gloria R Sue,Jennifer G Seither,Dung H Nguyen

doi:10.1016/j.jpra.2019.10.003

Gloria R Sue, Jennifer G Seither + Show 1 more

Open Access

https://doi.org/10.1016/j.jpra.2019.10.003

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Journal: JPRAS Open	Publication Date: Nov 5, 2019
Citations: 15	License type: cc-by

Affiliation: Stanford Health Care

Abstract

SummaryBackgroundBreast reconstruction improves the psychological well-being of patients with breast cancer. Patients who complete nipple-areolar reconstruction are even more satisfied with their final reconstructive result. Nipple flattening is a common complication. We hypothesized that injectable soft-tissue filler can be used to augment nipple projection in patients who underwent breast reconstruction.MethodsThis is a retrospective study of patients who underwent breast reconstruction and desired an enhanced postoperative nipple projection. The patients underwent a single session of injection with a hyaluronic acid filler as an outpatient. The filler was injected intradermally at the base of the nipple until the desired nipple projection was obtained.ResultsTwelve patients and 22 breasts were included in this study. Enhanced nipple projection was observed in all cases, with an average increase of 3.0 mm in nipple height (range 2.5–4.5 mm). All injected nipples remained soft to the touch. All results were stable at a median of 7.5 months follow-up. No complications were observed.ConclusionsThe use of injectable fillers for enhanced nipple projection is a useful adjunct treatment in patients undergoing breast reconstruction. Advantages include the ability to obtain nipple projection in patients who opt to forgo nipple-areola reconstruction with local flaps, to augment reconstructed nipples in patients with thin mastectomy skin flaps especially following implant-based reconstruction, and to improve projection of the native nipple following nipple-sparing mastectomy. Another benefit of this adjunct treatment is that the injection is reversible. Filler injection is a safe and simple solution to the problem of insufficient nipple projection.

Highlights

Reconstruction of the nipple-areola complex is an integral component of breast reconstruction
Nipple-areola complex reconstruction is typically performed after the surgical creation of a breast mound, and is associated with an improved aestheticresult and increased patient satisfaction.[1,2,3]
Many surgical techniques have described for nipple-areola complex reconstruction

Summary

Introduction

Reconstruction of the nipple-areola complex is an integral component of breast reconstruction. Nipple-areola complex reconstruction is typically performed after the surgical creation of a breast mound, and is associated with an improved aestheticresult and increased patient satisfaction.[1,2,3] This sense of reconstructive completeness is observed in both unilateral and bilateral nipple reconstructions.[4] Nipple-areola complex reconstruction is a critical component of the breast reconstruction pathway that represents a restoration of a more natural appearance for the patient. Many surgical techniques have described for nipple-areola complex reconstruction. Breast reconstruction improves the psychological well-being of patients with breast cancer. Patients who complete nipple-areolar reconstruction are even more satisfied with their final reconstructive result. We hypothesized that injectable soft-tissue filler can be used to augment nipple projection in patients who underwent breast reconstruction

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Conclusion