Filler injection enhances the projection of the reconstructed nipple: an original easy technique

Background: A reduced nipple projection is the main reason for scarce satisfaction in nipple-areola complex reconstruction [9, 6] and many techniques have been proposed to sustain the reconstructed nipple. Method: 90 nipples in 70 patients were reconstructed either using a little wedge from labia minora (LMW) (70) or with nipple sharing (NS) (20). Two months after reconstruction, each reconstructed nipple was injected with DermaLive®. A second and a third injection were performed two and five months later. The injected volume was trimmed depending on the desired projection. Nipple projection was measured at the moment of implant, before and after each injection and six and twelve months after the last injection. Results: nipple projection was fully satisfactory in all cases and it was comparable to the contralateral nipple. Average nipple projection at six months was 5.8 mm in LMW patients, and 3.8 mm in NS ones (p<0.01) and respectively 5.6 mm and 3.5 mm at twelve months (p<0.01). No complication occurred, except one PET false positive. Conclusions: the method here proposed is simple, sure, and provides precise projection trimming with no need for intraoperatively forecasting tissue reabsorption. The result was better in the LMW group maybe because of their higher distensibility.