Summary
Maintaining projection and achieving patient satisfaction are two key challenges in
nipple reconstruction. Skin flap techniques such as CV and star flaps are currently
favoured. The “Hamburger” technique was described in 2007 using stacked conchal cartilage
discs within a skin flap construct, but no longer-term outcomes have been published.
We evaluate both projection and patient satisfaction following nipple reconstruction
using this technique. Twenty-three nipple reconstructions performed between 2007 and
2009 were reviewed. A standard pre-tattooed cylinder skin pattern was used with 3
punch biopsies of conchal cartilage harvested through a post-auricular incision. At
follow up, reconstructed nipples and donor sites were examined. Nipple projection
was measured bilaterally. Patients completed a short questionnaire. Mean follow up
was 24 months (9-31). Mean projection was 3.3 mm (range 0–5 mm) and was well matched
to the contralateral nipple. No donor site keloid scarring was observed, however cartilage
defects were easily palpable in all cases. Patients were satisfied or very satisfied
with overall cosmesis in 91% of cases. They were satisfied or very satisfied with
projection in 57% of cases. All patients found the donor site acceptable. With the
“hamburger” technique medium-term projection was maintained in most cases and was
comparable to published data for other techniques with or without cartilage. Patient
satisfaction was high even when projection was not well maintained. This suggests
that patient satisfaction and projection are not necessarily related. Donor site morbidity
was low.
Keywords
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Article info
Publication history
Published online: September 28, 2011
Accepted:
September 6,
2011
Received:
August 3,
2011
Footnotes
☆Work not currently submitted or presented elsewhere.
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
