• Journal of the Korea Academia-Industrial cooperation Society
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• v.8 no.5
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• pp.961-967
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• 2007

Automatic water feeding system for chickens is the one of the most important devices at poultry farms. Chickens drink water directly from a water feeder nipple of the automatic water feeder. Check valve inside the water feeder nipple is open when they drink water and is closed otherwise. There are two types of nipples. One is the piston nipple, and the other is the ball nipple. Because the nipple stick in the ball nipple can move freely, the sloping mechanism of the ball nipple works well. but it has complicated mechanism. On the other hand, the piston nipple has very simple structure, but its movement is limited so it can move only up-and-down. To overcome those limitation, the piston nipple with sphere valve seat face (sphere face piston nipple) has been developed and is just distributed at domestic markets. The experimental performance test of the commercialized sphere piston nipple has been conducted, and compared with the performance of the ball nipple and the piston nipple which are domestic products. As the result, sphere piston nipple shows excellent performance compared to that of the piston nipple but its performance is similar to ball type nipple.

• Korean Journal of Radiology
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• v.21 no.8
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• pp.955-966
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• 2020

Ultrasound (US) is an attractive diagnostic approach to identify both common and uncommon nipple pathologies, such as duct ectasia, nipple abscess, nipple leiomyoma, nipple adenoma, fibroepithelial polyp, ductal carcinoma in situ (restricted to nipple), invasive carcinoma, and Paget's disease. US is the reliable first-line imaging technique to assess nipple pathologies. It is useful to identify and characterize nipple lesions. Additionally, we have presented the mammography and MRI outcomes correlated with histopathologic features for the relevant cases.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.550-555
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• 2014

Background Nipple reconstruction following breast mound reconstruction is the final step in breast reconstruction. Although nipple reconstruction is a simple surgery, the psychological aspects of nipple reconstruction are thought to be important. Nipple projection is a key factor in determining patient satisfaction with the surgery. In the present study, the Hammond flap technique was introduced for nipple reconstruction. Methods Twenty-six patients who had undergone breast reconstruction from February 2008 to March 2012 were enrolled in this prospective study. All patients were evaluated based on preoperative photos, and their nipple diameters and heights were measured. Postoperative evaluation was conducted 3, 6, 9, and 12 months following nipple reconstruction. A questionnaire on patient satisfaction with the nipple reconstruction was administered 12 months after nipple reconstruction. Moreover, the same plastic surgeon scored nipple projection and overall cosmetic result of the new nipple. Results The mean projection was 4.4 mm (range, 3-6 mm), and it well matched the contralateral nipple. Twelve months following nipple reconstruction, the mean reduction rate in the nipple projection was 43.6%. Patients were satisfied or very satisfied with the nipple projection and the overall cosmetic result in 80.7% cases. Conclusions In the present study, compared with other techniques, the use of the Hammond flap technique in nipple reconstruction showed competitive results with regard to nipple projection and patient satisfaction.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.327-332
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• 2009

Purpose: Several methods of the nipple reduction have been reported. However, the methods described previously are difficult or have some demerits. This study proposes a simple technique for reduction of the nipple height as well as diameter. Methods: The purposed nipple height is marked. A pentahedral design of excision was marked around the nipple. Local anesthetic solution was infiltrated and a 4 - 0 Nylon traction suture was applied at the nipple apex. Excision of the nipple inside both two triangles and a rectangle was made. Remaining two flaps were approximated using 5 - 0 Nylon simple interrupted sutures. However, a part of wound closure was not done in the central area of the nipple. Results: 83 patients(166 nipples) underwent this procedure from December 1999 to December 2008. Follow up ranged from 6 months to 2 years with a mean of 10 months. 78 patients were female and 5 patients were male. No major complication occurred and remaining scars were very inconspicuous. Conclusion: This simple technique has the advantage of nipple reduction in both height and diameter, and provides good aesthetic outcomes.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.422-427
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• 2009

Purpose: Breast cancer is second most common cancer in women. Almost of patients with breast cancer treated with mastectomy undergoes breast reconstruction. Nipple reconstruction is an important step in breast reconstruction. Many surgeons have investigated of nipple reconstruction using the flap technique after breast reconstruction with the autologous tissue. The objective of this study is to evaluate the results of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. Methods: From April 2006 to May 2008, the authors treated 17 patients of nipple reconstruction using C - V flap technique, who were received breast reconstruction with the only breast expander. We have predicted decrease of the size of reconstructed nipple and designed flap a little larger than wanted nipple size. Nipple splint was applied for 4 - 6 months for minimizing decrease of the size of reconstructed nipple. The diameter and height of the reconstructed nipple were measured and patient's satisfaction score was assessed. Results: Mean follow-up duration was 12.5 months. Among the 17 patients, the average absorption rate by height of nipple was 47.0%. Partial necrosis was noted in 1 case, and treated well with conservative management. There was no other significant complications noted. Patient's satisfactory score was assessed by the height, design and location of the nipple. The average of satisfaction score was 85%, 68%, 62% and total average was 83%. Conclusion: The authors experienced 17 patients of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. The absorption rate of the size of the nipple, complications and patient's satisfactory score of this study were similar to those of nipple reconstruction after breast reconstruction with the autologous tissue. It is expected that nipple reconstruction after breast reconstruction with the only breast expander is safe and reliable. It is considered that a long - term study is necessary.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.590-598
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• 2021

Background Although the initial projection after primary nipple reconstruction is excellent, nipple projection gradually flattens in most cases due to multiple causes. Although various methods have been reported to rebuild the nipple after nipple flattening, the most effective method of secondary nipple reconstruction remains unknown. The aim of this study was to review our institution's experiences with secondary nipple reconstruction. Methods We conducted a retrospective review from March 2012 to January 2019. We performed secondary nipple reconstruction if the primary reconstructed nipple height differed by more than 6 mm from the normal nipple height. We chose the method of nipple revision according to the degree of tissue scarring and the remaining nipple projection. Results We performed secondary nipple reconstruction on a total of 27 nipples, using purse-string sutures for 19 nipples and star flaps in eight nipples. The median follow-up period was 8 months (range, 6-19 months) after the final nipple reconstruction. Among the 19 nipples reconstructed using purse-string sutures, 10 (53%) demonstrated acceptable projection of more than 5 mm. Among the eight nipples reconstructed using star flaps, six (75%) showed acceptable projection of more than 5 mm. Most of the patients (73%) were satisfied (scores of 4 or 5) with the nipple reconstruction overall. Conclusions Few studies have presented favorable outcomes of secondary nipple reconstruction. When the star flap and purse-string suture methods were used depending on the remaining nipple height and scarring, appropriate projection could be achieved.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.76-84
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• 2005

Immediate breast reconstruction in breast cancer patients is universalized and now with a wide variety of methods to choose from, we can select a breast reconstruction method according to the patient's condition. Among these methods, immediate breast reconstruction with TRAM free flap is the most commonly used. Nipple reconstruction is usually performed as a secondary procedure, reconstructed. Nipple is reconstructed with contralateral nipple composite graft or with local flap. Areola is reconstructed with skin graft and tattooing. Therefore, to reconstruct complete breast, two or more staged operations are needed and are troublesome to both the surgeon and the patient. If we could reconstruct breast mound and nipple at same time, we would reduce the operative stages and heighten the patient's satisfaction. The author performed delayed or immediate breast reconstruction with TRAM free flap and nipple reconstruction at the same time. If the TRAM flap was to situate in the whole of the breast or at the center of the breast mound, nipple was reconstructed with a local flap from the TRAM flap. If the TRAM flap was not situated in center of breast mound, nipple was reconstructed with a local flap from remnant breast skin. Immediate nipple reconstructions in breast reconstruction consisted total of 22 cases. Among these, delayed breast reconstruction were 5 cases and immediate breast reconstruction were 17 cases. According to patient's condition and mastectomy method, nipple reconstruction method was selected; nipple reconstruction with contralateral nipple composite graft(3 cases); nipple reconstruction with remnant breast skin(6 cases); nipple reconstruction from flap margin(10 cases); nipple reconstruction with prefabricated nipple on flap(3 cases). Malposition of the reconstructed nipple was the most common and serious complication(6 cases). The other complications were atrophy of the nipple(1 case), and necrosis(1 case). Reconstruction of the breast and nipple at the same time can reduce the need of a secondary operation and use remnant skin or redundant flap tissue maximally. On the other hand, it must be considered that position and shape of nipple could be deformed, because the nipple reconstruction is performed before the shape of reconstructed breast settles completely. Prudent attention is needed, because the danger of complication is higher than delayed nipple reconstruction.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.401-407
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• 2011

Purpose: A number of flap for nipple reconstruction have been well described in the literature. However, most of these techniques do not permit the reconstruction of a projecting nipple and all are hampered to some extent by long-term loss of nipple projection. The objective of this study is to evaluate the long-term result and clinical efficacy of nipple reconstruction using skate flap technique after breast reconstruction. Methods: A retrospective chart review was carried out on 23 patients who underwent 25 nipple reconstructions. In those patients with greater than 10 mm nipple projection, reconstruction with skate flap and full-thickness skin graft and/or tattooing was performed. Maintenance of nipple projection was then carefully assessed over one-year follow-up. The following factors were analyzed: type of breast reconstruction, type of areola reconstruction, followup period, decrease in nipple projection, complication, and whether secondary nipple reconstruction was necessary and/or performed. Results: Breast reconstructions were performed in 17 patients with free transverse rectus abdominis musculocutaneous flap, 3 patients with extended latissimus dorsi musculocutaneous flap, and 3 patients with expander and implant. The mean follow-up after nipple reconstruction was 17 months. Mean loss of projection were $17.0{\pm}13.99%$, $25.0{\pm}12.70%$, $30.0{\pm}12.57%$ and $30.8{\pm}12.49%$ at 3, 6, 9 months and over one year, respectively. The greatest decrease in projection was noted in the first 3 months following surgery. Conclusion: These results indicated that nipple reconstruction with skate flap showed about 70 percent of the projection achieved over one year postoperation. Therefore, the skate flap may be a reliable method of nipple reconstruction in those patients with greater than 10 mm nipple projection.

• Archives of Plastic Surgery
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• v.43 no.5
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• pp.470-473
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• 2016

Nipple-areolar complex (NAC) reconstruction is the final step in the long journey of breast reconstruction for mastectomy patients. Successful NAC reconstruction depends on the use of appropriate surgical techniques that are simple and reliable. To date, numerous techniques have been used for nipple reconstruction, including contralateral nipple sharing and various local flaps. Recently, it has been common to utilize local flaps. However, the most common nipple reconstruction problem encountered with local flaps is the loss of nipple projection; there can be approximately 50% projection loss in reconstructed nipples over long-term follow-up. Several factors might contribute to nipple projection loss, and we tried to overcome these factors by performing nipple reconstructions using a boomerang flap technique, which is a modified C-V flap that utilizes the previous mastectomy scar to maintain long-term nipple projection.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.202-205
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• 2010

Purpose: Male nipple hypertrophy is a rare condition but is a social embarrassment for individual. The currently available techniques of nipple reduction already described in the literature for female patients are discussed, but the goal of treatment is different in male patients. In male patient, the diameter as well as vertical height should be reduced simultaneously to achieve better aesthetic results. Our new technique can reduce the diameter of the hypertrophic nipple as well as the vertical height efficiently and simply. Methods: A 19-years-old man with nipple hypertrophy on the right chest presented. The flap is designed based on the site of left nipple, symmetry, the diameter, and the projection desired. The widths of the V flaps determine projection, whereas the diameter of the C flap determines the diameter of the nipple and top of the new nipple. Unnecessary hypertrophic tissues are extirpated and the V flaps are elevated. The nipple base is reduced by purse-string suture technique. The V flaps are wrapped around, and C flap is used as a cap. Results: No complication including nipple necrosis or sensory loss were found during follow-up period. The normal symmetry of the nipple contour was restored. Conclusion: We describe a simple technique for male nipple reduction using a C-V flap with purse-string suture. In our experience, this technique has provided good aesthetic result and patient satisfaction.