Triple-V flap: Nipple reconstruction using a modified C-V flap technique for long-lasting improvement of projection

Francesco Klinger, Fabio Caviggioli, Valeriano Vinci, Davide Forcellini, Luca Maione, Andrea Lisa, Marco Klinger

Research output: Contribution to journalArticlepeer-review


Background: Reconstruction of the nipple-areola complex is the last procedure in breast reconstruction after mastectomy. Various techniques have been described, but the creation of a long-lasting projection represents a challenge in plastic surgery causing frequent nipple projection loss. Methods: From December 2008 and September 2010, we performed 43 nipple reconstructions using our new technique named "triple-V flap." This procedure is similar to C-V flap but uses a further V limb area that is de-epithelialized and provides significant support to the new nipple. Clinical assessment was performed with a caliper measuring nipple projection at 1, 6, and 12 months after the surgical procedure. Results: We evaluated the triple-V nipple reconstruction technique in 43 patients. Reconstructed nipple projection ranged between 3.3 and 6.4 mm (mean 4.8 mm). Mean decrease in nipple projection was 0.2 mm at 1 month, 1.4 mm at 6 months, and 1.6 mm at 1 year. After 1 year, mean nipple projection decrease was 34 %. Conclusions: Our triple-V technique allows the maintenance of long-lasting projection of the reconstructed nipple at 12 months after surgery. Ease and speed of execution made our technique usable in all patients who need to complete the breast reconstruction process. Level of Evidence: Level IV, therapeutic study.

Original languageEnglish
Pages (from-to)689-692
Number of pages4
JournalEuropean Journal of Plastic Surgery
Issue number11
Publication statusPublished - Nov 2013


  • Breast reconstruction
  • Local flap
  • Nipple reconstruction
  • Triple-V flap

ASJC Scopus subject areas

  • Surgery

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