TY - JOUR
T1 - Single-stage nipple-areolar complex reconstruction technique, outcomes, and patient satisfaction
AU - Liliav, Benjamin
AU - Loeb, Jennifer
AU - Hassid, Victor J.
AU - Antony, Anuja K.
N1 - Publisher Copyright:
Copyright © 2013 by Lippincott Williams & Wilkins.
PY - 2014
Y1 - 2014
N2 - Introduction: Nipple-areolar reconstruction (NAR) is the final phase of breast reconstruction and is associated with increased patient satisfaction. Nipple-areolar reconstruction is typically performed in 2 separate stages, which include nipple reconstruction and tattooing of the nipple-areolar complex (NAC). Previous studies have demonstrated that increased duration of the reconstruction is associated with decreased patient satisfaction. Because a 2-stage reconstruction prolongs the reconstructive process, we introduce a simple and novel method of single-stage NAR (SS NAR), which combines the use of local flaps for nipple reconstruction and medical tattooing of the NAC in 1 session and delivers predictable outcomes with high patient satisfaction. Methods: A retrospective chart review of patients who underwent SS NAR at our institution during the period from September 2010 to May 2012 was performed. Patient demographics, complications, outcomes, and overall patient satisfaction were assessed. A modified questionnaire (Likert scale) was used to assess patient satisfaction of nipple size, color, shape, and projection. Results: Twenty-nine SS NARs were performed in 18 patients: 7 unilateral and 11 bilateral. Mean age was 45 years (range, 34-60 years). No major complications were identified. Mean length of follow-up was 10 months (range, 2-22 months). A 17% complication rate was observed: 14% (4/29) had irregular dye uptake of the areola, and 3% (1/29) had dehiscence from silicone guard pressure on the incision. Two patients underwent revisions: one patient underwent additional tattooing, and the other required flap readvancement and implant downsizing secondary to the wound dehiscence. We obtained a 70% survey response rate with 100% of responders who reported that they were "very satisfied" with NAC in each dimension. Conclusions: Our study demonstrates that SS NAR is a safe procedure with reproducible, excellent clinical results and very low complication rates or need for revisions. This method is cost-effective, convenient for the patient, and shortens patient recovery time with high patient satisfaction.
AB - Introduction: Nipple-areolar reconstruction (NAR) is the final phase of breast reconstruction and is associated with increased patient satisfaction. Nipple-areolar reconstruction is typically performed in 2 separate stages, which include nipple reconstruction and tattooing of the nipple-areolar complex (NAC). Previous studies have demonstrated that increased duration of the reconstruction is associated with decreased patient satisfaction. Because a 2-stage reconstruction prolongs the reconstructive process, we introduce a simple and novel method of single-stage NAR (SS NAR), which combines the use of local flaps for nipple reconstruction and medical tattooing of the NAC in 1 session and delivers predictable outcomes with high patient satisfaction. Methods: A retrospective chart review of patients who underwent SS NAR at our institution during the period from September 2010 to May 2012 was performed. Patient demographics, complications, outcomes, and overall patient satisfaction were assessed. A modified questionnaire (Likert scale) was used to assess patient satisfaction of nipple size, color, shape, and projection. Results: Twenty-nine SS NARs were performed in 18 patients: 7 unilateral and 11 bilateral. Mean age was 45 years (range, 34-60 years). No major complications were identified. Mean length of follow-up was 10 months (range, 2-22 months). A 17% complication rate was observed: 14% (4/29) had irregular dye uptake of the areola, and 3% (1/29) had dehiscence from silicone guard pressure on the incision. Two patients underwent revisions: one patient underwent additional tattooing, and the other required flap readvancement and implant downsizing secondary to the wound dehiscence. We obtained a 70% survey response rate with 100% of responders who reported that they were "very satisfied" with NAC in each dimension. Conclusions: Our study demonstrates that SS NAR is a safe procedure with reproducible, excellent clinical results and very low complication rates or need for revisions. This method is cost-effective, convenient for the patient, and shortens patient recovery time with high patient satisfaction.
KW - Breast cancer
KW - Breast reconstruction
KW - Flap reconstruction of nipple
KW - Nipple projection
KW - Nipple reconstruction
KW - Nipple-areolar reconstruction
KW - Patient satisfaction with nipple reconstruction
KW - Tattooing of nipple-areolar complex
UR - http://www.scopus.com/inward/record.url?scp=84926642232&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84926642232&partnerID=8YFLogxK
U2 - 10.1097/SAP.0b013e318276dac0
DO - 10.1097/SAP.0b013e318276dac0
M3 - Article
C2 - 24135688
AN - SCOPUS:84926642232
SN - 0148-7043
VL - 73
SP - 492
EP - 497
JO - Annals of plastic surgery
JF - Annals of plastic surgery
IS - 5
ER -