L-Shaped nipple reconstruction: a novel technique to improve patient satisfaction outcomes.

Introduction: Nipple reconstruction is the final stage of breast reconstruction and performed after acceptable breast mound shape and symmetry has been achieved. Here is a description of an original technique of L shaped nipple reconstruction to address issues such as transverse mas-tectomy scar which lies at the Neo nipple position.

Aim: The objective of this study is to describe an original tech-nique of nipple reconstruction, using a combination of random flap and dermal graft; and also measures patient satisfaction of outco-mes. This original technique is set to overcome challenges of nipple reconstruction such as correct positioning, maintaining adequate projection and creating an almost inconspicuous scar.

Methods: 31 patients underwent the L-shaped nipple reconstruction between 2011 and 2016 at our Breast Unit. Complications and outcomes were analysed and compared with 59 patients who underwent traditional CV flap during the same study period (total N=90, i.e., L flap n=31 and CV flap=59).

Results: There was no statistically significant difference in complication rates between traditional CV flap (9.7%) and L-shaped (13.6%) nipple reconstructions (Fishers exact test p=0.74). In our study cohort undergoing L flap nipple reconstruction, 94% were either pleased or very pleased with their decision to have undergone nipple reconstruction and 93% would either strongly or very strongly recommend it to a friend.

Conclusions: The innovative L-shaped nipple reconstruction has positive patient satisfaction out-comes and is a very suitable alternative to traditional nipple reconstruction such as CV flap.