Donor-Site Morbidity and Patient Satisfaction Using a Composite Nipple Graft for Unilateral Nipple Reconstruction in the Radiated and Nonradiated Breast
Bibliographic record
Abstract
BACKGROUND: The number of techniques available for nipple reconstruction underscores the notion that achieving an acceptable result remains a challenge. To better assess the value of a composite nipple graft in unilateral breast reconstruction, a study was performed to evaluate donor-site morbidity and patient satisfaction using a composite nipple graft for unilateral nipple reconstruction following mastectomy and reconstruction in radiated and nonradiated patients. METHODS: A retrospective chart review of all patients who underwent composite nipple reconstruction between October of 1993 and February of 2010 was performed. Medical records were reviewed for outcomes and complications. Each patient was asked to complete a previously validated survey to rate color and projection of both nipples, sensation, and contractility of the donor nipple, and whether she would, in retrospect, have the procedure again. RESULTS: Fifty-nine patients were identified who underwent nipple reconstruction using a composite nipple graft. Thirty-four patients (57.6 percent) responded to the survey. Four surveys were returned due to an invalid address. Average time to breast mound completion was 6 months. Average time to complete nipple reconstruction was 3.6 months after breast mound completion. Ninety-seven percent of the reconstructions were successful. CONCLUSIONS: Composite nipple reconstruction is a useful technique that should be considered in unilateral nipple reconstruction and should be especially considered in patients whose breast has been irradiated, for which flap reconstruction for the nipple can be riskier. Although it is not possible to use in all patients, no other technique provides a nipple reconstruction that can so closely match the contralateral side in color, texture, and overall appearance.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".