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Introduction: The algorithm for reconstruction options for lower extremity soft-tissue defects depends on the location, size, and depth of the wound. Regional options include muscle, fasciocutaneous, perforator, supramalleolar, and sural flap. In this study, we aimed to evaluate the return time of postoperative sensory innervations in patients whose reconstruction was performed with a reverse flow sural flap in distal third lower extremity injuries. Materials and Methods: Patients with lower extremity injuries, treated between September 2018 and December 2021, were retrospectively evaluated in terms of sensory innervation of the sural flap at 1, 6, 12, and 18 months postoperatively. Heat, cold, pain, stereognosis, two-point discrimination, and superficial and deep sensory examinations were examined in stages. Results: A total of 12 patients were evaluated, 7 (58.3%) of whom were male and 5 (41.6%) were female. The mean age of the patients was 42.08 years. The mean follow-up period of the patients was 20 months. In the acute postoperative follow-up of the operated patients, infection was observed in three patients and venous congestion in one patient. Total flap loss was not observed in any patient. The superficial sensory test and the deep sensory test did not return until a mean of 6 months, and the stereognosis test did not return until 1 year, while the sensation of pain returned at an average of 18 months, and the heat, cold, and two-point discrimination tests did not return during follow-up in most patients. Conclusion: The reverse flow sural flap is a reconstruction option known to have rapid neurosensory recovery. The exact timing to minimize the risk of trauma that may occur in the flap area is an average of 18th month. Although larger studies are needed to support these results, studies to accelerate the sensory innervation of this flap are needed.

Aims: The aim of this study was to evaluate the reliability of the upper breast border (UBB) in determining the new location of the nipple and to objectively analyze long-term nipple position compared to pre-operative markings. Patients and Methods: Thirty-eight patients (76 breasts) patients who underwent superomedial pedicle, reverse-T scar breast reductions and who had long-term (>12 months) follow-up data were included. The sternal notch to the nipple, nipple to inframammarian fold (N-IMF), nipple to chest midline, and areola diameter were measured and recorded at the time of preoperative, markings, and long-term follow-up visit. Statistical Analysis Used: The differences in measurements were compared using a paired, two-tailed T-test, and a P < 0.05 was considered statistically significant. Results: The average follow-up time was 17.9 months (range 12–41 months). The nipple was located, on average, 0.95 cm lower on postoperative assessment compared to preoperative marking (P = 0.060). The nipple was located, on average, 0.75 cm lateral on postoperative assessment compared to preoperative marking (P < 0.001). The average postoperative increase in the N-IMF distance between marking and the long-term follow-up visit was 1.75 cm (P < 0.001). The areola diameter was increased 0.21 cm on postoperative assessment compared to preoperative marking (P < 0.001). Conclusions: The nipple position moved down and the N-IMF distance was greater than planned. However, the nipple was usually located at the area of the greatest projection of the breast due to almost equal elongation of the superior and inferior poles. The outcome of breast reduction procedures in which the postoperative nipple position is planned using the UBB was good.