A Modified Technique for Nipple-Areola Complex Reconstruction

2This book, written by leading international experts, deals exclusively with reconstruction techniques for the Nipple-Areolar Complex (NAC). The first chapters present the history of the Nipple-Areolar Complex reconstruction and the anatomy of this part of the body. After discussing the abnormalities of the Nipple-Areolar Complex and how to prevent Nipple-Areolar Complex disorders, the book provides extensive documentation on techniques for correcting nipple hypertrophy, nipple inversion, and for increasing nipple projection. Readers will also find helpful information of malposition and tumors of the Nipple-Areolar Complex, as well as complications that can arise during the various surgical techniques. The book offers an invaluable guide for residents and fellow, practicing and highly experienced plastic surgeons, general surgeons, and those in cosmetic surgical subspecialites.nonenoneParodi, Pier Camillo; Almesberger, DariaParodi, Pier Camillo; Almesberger, Dari

The v-y latissimus dorsi musculocutaneous flap in the reconstruction of large posterior chest wall defects.

Posterior chest wall defects are frequently encountered after excision of tumors as a result of trauma or in the setting of wound dehiscence after spine surgery. Various pedicled fasciocutaneous and musculocutaneous flaps have been described for the coverage of these wounds. The advent of perforator flaps has allowed the preservation of muscle function but their bulk is limited. Musculocutaneous flaps remain widely employed. The trapezius and the latissimus dorsi (LD) flaps have been used extensively for upper and middle posterior chest wounds, respectively. Their bulk allows for obliteration of the dead space in deep wounds. The average width of the LD skin paddle is limited to 10-12 cm if closure of the donor site is expected without skin grafting. In 2001 a modification of the skin paddle design was introduced in order to allow large flaps to be raised without requiring grafts or flaps for donor site closure. This V-Y pattern allows coverage of large anterior chest defects after mastectomy. We have modified this flap to allow its use for posterior chest wall defects. We describe the flap design, its indications, and its limitations with three clinical cases. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266