Postburn reconstruction of nipple–areola complex

Reconstruction of burned nipple–areola complex is a significant problem. Many techniques are available. Most have been fraught with loss of nipple projection within 6 months. Local flaps seem to give better results. Drawbacks of these procedures in burned patients are excessive nipple flattening and difficulty in nipple reconstruction due to the low amount of subcutaneous fat and thin dermis because of tight scar. The modified star flap is a derivative of the skate design and includes the significant advantage of primary closure of the donor site. This article describes some modifications to the star flap, intended to decrease nipple flattening and improve flap stabilization, even in burned breasts. We performed seven nipple reconstructions in six young females who were victims of childhood burn injury. The final projection of nipples was 5 ± 1 mm. We think that our technique is a good alternative to previous ones and may be applied in all burned patients.