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The full nipple-areolar complex of dogs has been successfully removed, cryopreserved using a controlled-rate freeze protocol, and reimplanted without loss of viability. The technique for reimplantation calls for the use of a new fixed double bolus technique that prevented dislodging or contamination in all but 2 cases. The feasibility of performing this procedure in humans is discussed.

The authors' experience in 100 consecutive cases of breast reconstruction after mastectomy, all done by one standardized method, is presented. An analysis is made of the types of candidates, their eligibility for the procedure, lengths of stay in the hospital, complications, and results. Several representative cases are shown.

A new method for nipple transposition employing a superomedial dermal pedicle is described for use in reduction mammaplasty and dermal mastopexy. The advantages include superior mobility, viability, sensation and normal appearing nipples and areolae.

We present a method of closing chest wall defects with a large bepedicled flap from the adjacent chest wall and abdominal tissue.

In standard skin flaps in the rat, the effect of a delay was undetectable for the first 3 weeks and the maximum benefit was not apparent until the sixth week. At all time intervals the delay phenomenon was not as pronounced in the rat as in other species. The delay phenomenon in the rat lasts at least 30 weeks. The rat does not appear to be an ideal model for the study of skin flaps.

Having learned that healed mastectomy wounds will stretch sufficiently to accommodate an implanted prosthesis, we must pay more attention to the position, and shape of the breast mound created by the prosthesis. We have briefly discussed our methods and the considerations we feel are important in this regard, but, even after extensive experience, we confess that the problems are still with us. Clearly, surgical methods and prostheses must improve.

On the basis of independent clinical and pathological screens, mastectomy patients can be effectively classified into high-risk and low-risk groups for neoplastic involvement of the nipple-areolar complex. Clinical criteria included gross nipple signs, cutaneous signs, and tumor location, size, and bilaterality. Pathological criteria comprised subareolar involvement multicentricity, and nodal involvement. Fifty consecutive women undergoing mastectomy for cancer at the New York Hospital-Cornell University Medical Center underwent classification into high-risk and low-risk groups on the basis of these criteria. Fifty-four percent of the patients studied passed the screens and were included in the low-risk group. The incidence of nipple involvement in this group was 0. In the remaining 46%, failing either or both of the screens and constituting the high-risk group, the incidence of neoplastic involvement of the nipple was 35%. All involved nipples fell into this group.

A "delay" of a pedicle flap stimulates improvement in the flap circulation, probably through partial ischemia. The degree of stimulation prsent at any given time is inversely proportional to the length of time that has passed after the delay because progressive revascularization across the delay lines reduces the ischemis stimulus. This revascularization can ve prevented by placing silicone elastomers (Silastic) sheeting between the flap and its bed.