Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
Yes
Please specify date...: OWNER
and status : 2 YEARS

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: The goal of this manuscript is to analyze the main NAC reconstruction techniques performed in a Brazilian reference center between 2017 and 2022, comparing outcomes and complications. Secondarily, we determine the epidemiological profile, the breast reconstruction techniques used and the surgical time for NAC reconstruction performed in this population.

Introduction: Reconstruction of the nipple-areola complex (NAC) is one of the surgeries that represents the rehabilitation of breast cancer patients. Several techniques have been described over the years aiming to reconstruct a NAC with a similar appearance of the original, mainly in relation to the projection of the papilla, shape, texture and color of the areola. This is typically accomplished with the use of local flaps and/or distant grafts options.

Materials / method: Epidemiological, observational and retrospective study performed in the Plastic Surgery Service of Hospital Federal de Ipanema from January 2017 to December 2022. The data was collected by electronic and physical records. A total of 15 NAC reconstructions were performed with equivalent laterality. The mean age was 53.73 years, 60% were health and 46.67% were overweight (BMI > 25). All patients undergoing total mastectomy electively due to breast neoplasia and 8, 5 and 2 patients had their breast reconstruction with breast implant, latissimus dorsi and rectus abdominis free flap, respectively.

Results: The NAC reconstructions occurred between the 3rd and 5th surgical time with an average of 30.53 months. Among the surgical techniques, the the most common was the contralateral nipple graft (60%), followed by the 'skate' technique (26.66%), the star technique (6.67%) and the cylinder technique (6.67%) associated with a skin flap from inguinal area. The majority (73.33%) did not have prior local radiotherapy. The overall complication rate was 13.5% ( local infection and partial necrosis) and only one patient required a new local approach (6.63%).

Conclusion: NAC reconstruction adds an important aesthetic and psychological point of view in the rehabilitation of patients. The majority of the sample underwent NAC reconstruction after 30 months of breast reconstruction using the contralateral nipple graft technique associated with a skin flap from the inguinal donor area. There was a low complication and re-approach rate. The satisfaction rate is usually high and this approach contributes to patients' quality of life, stimulating the improvement of research about new concepts and techniques for NAC reconstruction.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: We present a minimally invasive technique that utilizes known complications of rhinoplasties to the patient’s benefit.

Introduction: Revision Rhinoplasty is one of the harder and sometimes dreaded but necessary aesthetic surgeries to perform. The scarring encountered makes it difficult and sometimes nigh impossible to delineate the planes between the skin and cartilage. Blood supply is also tenuous and changes in skin quality is evident. We present a simple technique for a patient who sustained pan facial fractures in 2009 and underwent 4 rhinoplasties thereafter in attempts to correct her nasal deformity. The latest of which was a dorsal augmentation with a silicone implant in 2013.

Materials / method: She had a deviation of the implant to the right, shortened nose with a contracted right soft triangle and alar retraction. Fat harvested from abdomen (120cc) and Centrifuged 3 mins at 3000 rpm and was nano processed. A stab incision was made through previous right infracartilaginous incision. Severe scaring was noted but capsule surrounding the previous silicone implant was identified. Sharp dissection to her glabella and, right nasal dorsum tip and alar was carried out.1cc of fat was then injected into multiple small aliquots into the intracapsular plane and molded to symmetry.

Results: The nasal tip deviation was improved, with increased suppleness in scar
tissue and decreased scar contracture noted. The patient was pleased with the
outcome and reported minimal pain post operatively owing to the endonasal
approach undertaken.

Conclusion: Less may very well be more in a situation whereby multiple attempts at revision rhinoplasties resulted in minimal improvement. By taking advantage of a complication whereby a stable capsule has been formed and considering a more minimalist approach in problem solving, there can be good outcomes for the patient as demonstrated.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability