Projection and patient satisfaction using the “Hamburger” nipple reconstruction technique

Journal of Plastic, Reconstructive & Aesthetic Surgery, 10/11/2011

Jones AP et al. – With the “hamburger” technique medium–term projection was maintained in most cases and was comparable to published data for other techniques with or without cartilage. Patient satisfaction was high even when projection was not well maintained. This suggests that patient satisfaction and projection are not necessarily related. Donor site morbidity was low.


  • Twenty-three nipple reconstructions performed between 2007 and 2009 were reviewed.
  • A standard pre-tattooed cylinder skin pattern was used with 3 punch biopsies of conchal cartilage harvested through a post-auricular incision.
  • At follow up, reconstructed nipples and donor sites were examined.
  • Nipple projection was measured bilaterally.
  • Patients completed a short questionnaire.
  • Mean follow up was 24 months (9-31).


  • Mean projection was 3.3 mm (range 0–5 mm) and was well matched to the contralateral nipple.
  • No donor site keloid scarring was observed, however cartilage defects were easily palpable in all cases.
  • Patients were satisfied or very satisfied with overall cosmesis in 91% of cases.
  • They were satisfied or very satisfied with projection in 57% of cases.
  • All patients found the donor site acceptable.

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