Successful reconstruction using a de-epithelialized rectangular flap on a nipple necrosis site after DIEP flap-based breast reconstruction: a case report

Postmastectomy nipple necrosis is a factor that leads to poor aesthetic outcome in breast reconstruction because of the unique projective structure nipple. We present case successful using de-epithelialized rectangular flap. A 45-year-old woman was diagnosed with left cancer. She had vertical scar below nipple-areolar complex due previous reduction mammoplasty. underwent nipple-sparing mastectomy, deep inferior epigastric artery perforator (DIEP) flap, and contralateral reduction. After operation, gradually necrotized, full-thickness observed on postoperative day 12. For reconstruction, we designed 38×23 mm flap from DIEP considering diameter (12 mm), protrusion (2 ipsilateral mastectomy skin thickness (15 mm). The area contact placed defect after de-epithelialization. survived slight loss projection. When unexpected occurs DIEP-based designing tissue feasible reconstructive method consider.