Immediate nipple reconstruction with a C‐V flap and areolar reconstruction with an autograft of the ipsilateral areola

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Numerous oncoplastic surgery (OPS) techniques have been developed as standard surgical treatments for breast cancer. Reconstruction of the nipple‐areola complex (NAC) is important for achieving maximum symmetry in breast reconstruction.
Various surgical techniques for nipple reconstruction have been developed in an effort to maintain nipple projection for as long as possible. Among the various flaps, such as the C‐V flap,1 S flap,4 star flap,6 and cartilage insertion technique,8 the C‐V flap is a relatively quick and effective form of nipple reconstruction using local tissue.
In contrast, little information is available regarding areola reconstruction.1 In most cases of areola reconstruction, grafts using distant pigmented skin or tattooing have been used.5 Although tattooing is a simple and effective nonsurgical method of areola reconstruction, it requires advanced technical skills to achieve staining that resembles a realistic areola, and it is associated with a risk of infection, especially on irradiated skin. Methods involving full‐thickness grafts using pigmented skin from the labia minora or upper inner thigh have yielded graft failure rates of 20–80% in various studies. Moreover, it is difficult to achieve a maximally realistic areola texture, including colour, morphology and sensation.12 Several recent studies have reported the creation of skin grafts using the contralateral areola, which has the texture of a real areola.1 However, donor site operations and morbidities are inevitable with this technique.
The authors performed OPS with NAC reconstruction for breast cancer with nipple invasion using an autograft of the ipsilateral areola. No donor site operation was necessary, and good cosmetic results were achieved.

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