Bell Flap Nipple-Areola Complex Reconstruction

Abstract

The bell flap nipple reconstruction is a single-stage surgical procedure designed to reconstruct a “lifelike” nipple-areola complex on most existing or reconstructed breast mounds by using only local tissues and no skin grafts. A premeasured circle and within it a centrally based bell-shaped skin pedicle flap are scratched on the skin of the new nipple site and then tattooed with a preselected pigment. The bell-shaped flap is raised, boxed, and wrapped around its base to form a new nipple. The rest of the skin and subcutaneous tissue inside the circle is partially released and sutured into a shallow cone to simulate a new areola. A purse-string suture around the outer skin circle is tightened as it “squeezes” the new nipple and areola well outside the breast mound. After inset, a new 3-D nipple-areola complex is made.