Cinnamon Roll Technique with WALANT for Nipple Reduction
Springer Science and Business Media LLC - Trang 1-8 - 2023
Tóm tắt
Nipple hypertrophy is a common esthetic problem in Asian women. Many patients are uncomfortable and seek plastic surgeons for correction. Although several reduction methods have been published, the new nipple size is not always decided by patients under conventional anesthesia. We describe a novel cinnamon roll technique with wide-awake local anesthesia no tourniquet (WALANT) to decrease pain, provide a bloodless field and allow on-table discussion of the ideal nipple size during surgery. Between November 2015 and October 2022, fifteen patients with 30 nipples were enrolled. The patient’s characteristic data, nipple height and width, and VAS while infiltration were recorded. Aesthetic results were evaluated by rating a satisfactory score from 0 to 10 at follow-up. Sensory recovery was also evaluated for 1, 3, 6, and 12 months sequentially after the surgery. Before surgery, the mean diameter and height of the nipples were 13.2 ± 1.8 mm and 12 ± 2.2 mm, respectively. Immediately after surgery, the mean diameter and height of the nipples were 8.8 ± 1.2 mm and 8.7 ± 1.2 mm, respectively. The mean VAS while infiltration was 1.3 ± 0.5 and the mean satisfactory score at the latest clinic follow-up was 9.3 ± 0.6. No complications such as nipple necrosis, infection, numbness or hypertrophic scar occurred. The mean clinical follow-up period was 3.4 months. Cinnamon roll technique with WALANT is a simple, safe and reliable method with short learning curve and high satisfaction. Our technique offers a chance for patients to control subjective pleasing size of their own nipples. 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 Table of Contents or online Instructions to Authors
www.springer.com/00266.
Tài liệu tham khảo
Cheng MH, Smartt JM, Rodriguez ED, Ulusal BG (2006) Nipple reduction using the modified top hat flap. Plast Reconstr Surg 118:1517–1525
Huang WC, Yu CM, Chang YY (2012) Geometric incision design for reduction nippleplasty. Aesthetic Plast Surg 36:560–565
Fanous N, Tawile C, Fanous A (2009) Nipple reduction - An adjunct to augmentation mammaplasty. Can J Plast Surg 17:81–88
Ferreira LM, Neto MS, Okamoto RH, Andrews Jde M (1995) Surgical correction of nipple hypertrophy. Plast Reconstr Surg 95:753–754
van Wingerden JJ (1997) Nummular nipple hypertrophy and repair as part of an aesthetic nipple-areola unit. Aesthetic Plast Surg 21:408–411
Tosti R, Rekant MS (2022) Wide awake local Anesthesia no tourniquet endoscopic cubital tunnel release. J Hand Surg Am 47:1022.e1021-1022.e1025
Connors KM, Guerra SM, Koehler SM (2022) Current evidence involving WALANT surgery. J Hand Surg Glob Online 4:452–455
Dar QA, Avoricani A, Rompala A, Levy KH, Shah NV, Choueka D, White CM, Koehler SM (2021) WALANT hand surgery does not require postoperative opioid pain management. Plast Reconstr Surg 148:121–130
Pina M, Cusano A, LeVasseur MR, Olivieri-Ortiz R, Ferreira J, Parrino A (2021) Wide awake local anesthesia no tourniquet technique in hand surgery: the patient experience. Hand (N Y): 15589447211058838
Ren M, Wang Y, Wang B (2013) Nipple reduction using a three-dimensional Z-shaped incision technique. J Plast Reconstr Aesthet Surg 66:770–775
Yu Y, Wei L, Shen Y, Xiao W, Huang J, Xu J (2017) Windmill flap nipple reduction: a new method of nipple plasty. Aesthetic Plast Surg 41:788–792
Frank SG, Lalonde DH (2012) How acidic is the lidocaine we are injecting, and how much bicarbonate should we add? Can J Plast Surg 20:71–73
Lalonde DH (2019) Latest advances in wide awake hand surgery. Hand Clin 35:1–6
Lalonde D, Martin A (2013) Epinephrine in local anesthesia in finger and hand surgery: the case for wide-awake anesthesia. J Am Acad Orthop Surg 21:443–447
Lalonde D, Bell M, Benoit P, Sparkes G, Denkler K, Chang P (2005) A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: the Dalhousie project clinical phase. J Hand Surg 30:1061–1067
Thomson CJ, Lalonde DH, Denkler KA, Feicht AJ (2007) A critical look at the evidence for and against elective epinephrine use in the finger. Plast Reconstr Surg 119:260–266
Sarhadi NS, Shaw Dunn J, Lee FD, Soutar DS (1996) An anatomical study of the nerve supply of the breast, including the nipple and areola. Br J Plast Surg 49:156–164
Hagert E, Lalonde, D (2015) Time to bury the adrenaline-myth!--Safe use of adrenaline anesthesia in hand surgery and orthopedics. Lakartidningen 112
Trøstrup H, Saltvig I, Matzen SH (2019) Current surgical techniques for nipple reduction: a literature review. JPRAS Open 21:48–55
Jin US, Lee HK (2013) Nipple reduction using circumcision and wedge excision technique. Ann Plast Surg 70:154–157
Basile FV, Chang YC (2007) The triple-flap nipple-reduction technique. Ann Plast Surg 59:260–262