To explore the application of nipple reconstruction using rib cartilage scaffold in breast reconstruction with implant.

The study reviewed 20 cases of breast cancer and one case of phyllodes tumor (involving nipple and areola) in the Department of Breast Surgery, Shenzhen Hospital of Peking University from June 2017 to June 2019. They all underwent nipple reconstruction using rib cartilage scaffold and breast reconstruction with silicone implant. Operation time, blood loss, length of hospital stay, pain, survival of reconstructed nipples, postoperative complications and patient satisfaction were recorded.

The surgery was successful in all cases. Operation time was (58.3±7.4) min (range: 40.0-71.0 min); postoperative blood loss was (14.7±3.1) ml (range: 10.0-20.0 ml); scores of postoperative pain was 2.5±0.5 (range: 2.0-3.0), indicating mild pain and discomfort. The length of postoperative hospital stay was (4.1±1.3) d (range: 3.0-7.0 d). Two patients had partial necrosis of papillary flaps, and blood supply of flaps were restored after dressing change. All patients were followed up for 6-24 months, median 13 months. All patients were satisfied with the reconstructed nipples, including 19 patients with excellently-reconstructed nipples, 2 with well-reconstructed nipples and none with poorly-reconstructed nipples.

For patients who cannot spare nipples in breast reconstruction, nipple reconstruction using rib cartilage scaffold has the advantages of less trauma, short recovery period, and less-demanding in techniques, worthy of clinical application.