Evaluation of four techniques for nipple reconstruction

ABSTRACT

Introduction:

Reconstruction of the nipple-areola complex represents the final and perhaps most difficult stage in breast reconstruction. Several techniques have been described; however, most of the methods do not seem to achieve adequate projection and are associated with the loss of projection over time, leading to an inadequate final aesthetic result. The objective of this study is to compare and evaluate the results and effectiveness of four different surgical nipple reconstruction techniques in the last 3 years.

Method:

Sixty-four reconstructed nipples were evaluated using the skate flap (n=17), double-opposing-tab flap (n=15), four petals (n=22), and contralateral nipple graft (n=10) techniques. The results were evaluated in the long term by a blinded examiner who classified the results as fully satisfactory, satisfactory, partially satisfactory, or unsatisfactory.

Results:

The nipple graft showed significantly better results than the other groups (p=0.012). There was no statistical difference when only the flaps (excluding the contralateral nipple graft) were evaluated (p=0.102). However, when evaluating the outcome of nipple reconstruction according to primary reconstruction type, no difference was observed among the groups (p=0.563).

Conclusion:

The contralateral nipple graft technique proved to be the most efficient method that yielded better results; however, no difference was seen among the other evaluated techniques. Hence, when the contralateral nipple graft technique is not possible, surgeons should select the one with which they are most familiar.

Keywords:
Breast Reconstruction; Nipple Reconstruction; Breast Cancer; Post-operative Complications