Secondary revision of nipple-areolar dislocation after breast reconstruction

Usually dislocation of the nipple-areolar complex in an axillar direction occurs after a breast cancer resection, especially a subcutaneous total mastectomy. The correction of this dislocation is very difficult. We tried to correct this dislocation by 1) a large myocutaneous flap, 2) Z-plasty for a transposition of the nipple-areola, 3) V-Y advancement of the nipple-areola, and 4) an areolar skin graft for transposition. We used the large skin island of the myocutaneous flap for correction of the wide dislocation of the nipple-areola. The Z-plasty was used for the nipple-areola that is close to the horizontal scar. The V-Y advancement is used for when the nipple-areola donor area can be closed by direct suture. The areolar small skin graft is used for slight discrepancy of the areolar position.