Table of Contents
Plastic Surgery International
Volume 2014, Article ID 194087, 6 pages
Clinical Study

Biologic Collagen Cylinder with Skate Flap Technique for Nipple Reconstruction

1Tierney Plastic Surgery, 2011 Church Street, Suite 805, Nashville, TN 37203, USA
2Cook Biotech Incorporated, 1425 Innovation Place, West Lafayette, IN 47906, USA

Received 6 February 2014; Revised 20 June 2014; Accepted 28 June 2014; Published 10 July 2014

Academic Editor: Nicolo Scuderi

Copyright © 2014 Brian P. Tierney et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A surgical technique using local tissue skate flaps combined with cylinders made from a naturally derived biomaterial has been used effectively for nipple reconstruction. A retrospective review of patients who underwent nipple reconstruction using this technique was performed. Comorbidities and type of breast reconstruction were collected. Outcome evaluation included complications, surgical revisions, and nipple projection. There were 115 skate flap reconstructions performed in 83 patients between July 2009 and January 2013. Patients ranged from 32 to 73 years old. Average body mass index was 28.0. The most common comorbidities were hypertension (39.8%) and smoking (16.9%). After breast reconstruction, 68.7% of the patients underwent chemotherapy and 20.5% underwent radiation. Seventy-one patients had immediate breast reconstruction with expanders and 12 had delayed reconstruction. The only reported complications were extrusions (3.5%). Six nipples (5.2%) in 5 patients required surgical revision due to loss of projection; two patients had minor loss of projection but did not require surgical revision. Nipple projection at time of surgery ranged from 6 to 7 mm and average projection at 6 months was 3–5 mm. A surgical technique for nipple reconstruction using a skate flap with a graft material is described. Complications are infrequent and short-term projection measurements are encouraging.