To the Editor.—I believe that the brief clinical note on carcinoma in a transplanted nipple by Dr Rose (Archives 1980;115:1131-1132) is very significant. Almost everyone who is involved in reconstructive surgery of the breast has eliminated the idea of transplanting the nipple to the groin and then transplanting it back to the reconstructed breast. The reason for elimination of this form of nipple reconstruction is twofold. First, there have been isolated incidents, as Dr Rose reported, of carcinoma transplanting into the groin at the base of the nipple. Second, by the time the nipple has been transplanted into the groin and back to the breast, the resulting nipple areola complex is fibrotic and depigmented, and does not have a normal appearance.
Most surgeons today use a full-thickness skin graft from the pigmented part of the groin where the skin pigment matches the contralateral areola in pigmentation, and a portion