Figure 3: A step-by-step illustration of the DPS technique.
A: Marking of the area to be excised (inner, continuous circle), this margin will close with the upper suture of the DPS. Marking of a second area at a distance equal to the desired projection of the new nipple (outer, broken circle), this will form the basis of the new nipple and will close with the lower/second suture.
B: Surgical excision of the marked area, containing the adenoma and adequate surrounding tissues.
Ci (anterior view) and Cii (side view): Closure of the wound. Inner circle is closed completely by a purse-string suture and forms the top of the nipple. The outer circle is closed by a second purse-string suture lower than the first one. The distance between the two creates a projection resembling the normal, contra-lateral nipple.
D: Final reconstructed nipple at follow-up. Despite some minimal flattening, there was adequate projection, along with the radial appearance of the area to maintain an aesthetically pleasing result.