Single-Stage Reconstruction of the Nipple-Areolar Complex: Outcomes and Patient Satisfaction

Reconstruction of the nipple-areolar complex has traditionally been performed in two stages, reconstruction of the nipple, followed by tattooing of the entire complex months later. This chapter discusses the emerging technique of performing the entire reconstruction in a single operation. In addition to the steps of the procedure, the text details elements of the operation that are improved upon with the single-stage technique. The chapter covers historical concerns and how those are addressed by current studies on the single-stage technique. The chapter provides a review of the available literature, discussing both variations in technique and clinical outcomes. Perhaps the most powerful determinant of clinical success in nipple-areolar complex reconstruction is patient satisfaction. This text demonstrates that the single-stage technique provides many advantages over the two-stage technique and may be the most effective method in achieving superior patient satisfaction.

[1]  M. McGrath Nipple-Areola Reconstruction: Satisfaction and Clinical Determinants by Mark A. Jabor, M.D. Payam Shayani, M.D., J.D. Donald R. Collins, Jr., M.D. Tomer Karas, M.D. Benjamin E. Cohen, M.D. , 2002 .

[2]  P. Cordeiro,et al.  Surgical Outcomes and Nipple Projection Using the Modified Skate Flap for Nipple-Areolar Reconstruction in a Series of 422 Implant Reconstructions , 2009, Annals of plastic surgery.

[3]  N. Hugo,et al.  Nipple—Areola Reconstruction with Intradermal Tattoo and Double‐Opposing Pennant Flaps , 1993, Annals of plastic surgery.

[4]  N. Martin,et al.  Patient satisfaction following nipple-areolar complex reconstruction and tattooing. , 2011, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[5]  A. Antony,et al.  Single-Stage Nipple-Areolar Complex Reconstruction Technique, Outcomes, and Patient Satisfaction , 2014, Annals of plastic surgery.

[6]  Tomer Z. Karas,et al.  Nipple‐Areola Reconstruction: Satisfaction and Clinical Determinants , 2002, Plastic and reconstructive surgery.

[7]  D. Shenaq,et al.  Patient-subjective cosmetic outcomes following the varying stages of tissue expander breast reconstruction: the importance of completion. , 2010, Breast.

[8]  S. Spear,et al.  Long‐Term Experience with Nipple‐Areola Tattooing , 1995, Annals of plastic surgery.

[9]  F. Roviello,et al.  Nipple-areola complex reconstruction techniques: A literature review. , 2016, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[10]  E. Halvorson,et al.  Three-Dimensional Nipple-Areola Tattooing: A New Technique with Superior Results , 2014, Plastic and reconstructive surgery.

[11]  J. Thomsen,et al.  Promising results after single-stage reconstruction of the nipple and areola complex. , 2013, Danish Medical Journal.

[12]  E. Vandeweyer Simultaneous Nipple and Areola Reconstruction: A Review of 50 Cases , 2003, Acta chirurgica Belgica.

[13]  Sami U. Khan,et al.  Modeling Fade Patterns of Nipple Areola Complex Tattoos Following Breast Reconstruction , 2014, Annals of plastic surgery.

[14]  L. Eskenazi A One‐Stage Nipple Reconstruction with the “Modified Star” Flap and Immediate Tattoo: A Review of 100 Cases , 1993, Plastic and reconstructive surgery.

[15]  J. Talbott Presidential address: Our patients' future in a changing world: the imperative for psychiatric involvement in public policy. , 1985, The American journal of psychiatry.

[16]  B. Teimourian,et al.  The propeller flap: A one-stage procedure for nipple-areola reconstruction , 2004, Aesthetic Plastic Surgery.

[17]  M. Dalal,et al.  Tattooing of the nipple-areola complex: review of outcome in 40 patients. , 2006, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[18]  J. W. Little,et al.  The Psychological Contribution of Nipple Addition in Breast Reconstruction , 1987, Plastic and reconstructive surgery.