The optimal reconstruction size of nipple-areola complex following breast implant in breast cancer patients

Nagura-Inomata, Naomi; Iwahira, Yoshiko; Hayashi, Naoki; Komiya, Takako; Takahashi, Osamu

doi:10.1186/s40064-016-2230-5

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…If darker, suitable donor sites include the labia minora and majora from the groin [ 16 , 17 ], the buttock [ 18 ] or the upper thigh [ 19 ], because skin harvested from these areas supposedly tends to hyperpigment [ 6 ]. Some propose harvesting the outer rim of the contralateral areola, which can be useful in patients with large NAC who would simultaneously benefit from an areolar reduction [ 20 ]. If no donor site is available, Seaman proposes using an acellular dermal matrix (Alloderm) as an onlay graft [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

Guiding Nipple-Areola Complex Reconstruction: Literature Review and Proposal of a New Decision-Making Algorithm

et al. 2020

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Background Nipple-areola complex reconstruction (NAR) most commonly represents the finishing touch to breast reconstruction (BR). Nipple presence is particularly relevant to the patient’s psyche, beyond any shadow of doubt. Many reconstructive options have been described in time. Surgery is easy, but final result is often disappointing on the long run. Methods The goal of this manuscript is to analyze and classify knowledge concerning NAR techniques and the factors that influence success, and then to elaborate a practical evidence-based algorithm. Out of the 3136 available articles as of August 8th, 2020, we selected 172 manuscripts that met inclusion criteria, which we subdivided into 5 main topics of discussion, being the various NAR techniques; patient factors (including patient selection, timing and ideal position); dressings; potential complications and finally, outcomes/patient satisfaction. Results We found 92 articles describing NAR techniques, 41 addressing patient factors (out of which 17 discussed patient selection, 14 described ideal NAC location, 10 described appropriate timing), 10 comparing dressings, 7 studying NAR complications, and 22 addressing outcomes and patient satisfaction. We elaborated a comprehensive decision-making algorithm to help narrow down the choice among NAR techniques, and choose the correct strategy according to the various scenarios, and particularly the BR technique and skin envelope. Conclusions No single NAR technique provides definitive results, which is why we believe there is no “end-all be-all solution”. NAR must be approached as a case-by-case situation. Furthermore, despite NAR being such a widely discussed topic in scientific literature, we still found a lack of clinical trials to allow for more thorough recommendations to be elaborated. Level of Evidence III This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

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Section: Resultsmentioning

confidence: 99%

Guiding Nipple-Areola Complex Reconstruction: Literature Review and Proposal of a New Decision-Making Algorithm

et al. 2020

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“…Such surgery commonly involves relocation of the nipple-areola complex, with a focus on the esthetic appearance of its location post-surgery [1][2][3][4]. Several studies have further sought to preserve nipple prominence [5][6][7][8][9], some of which have involved novel suturing techniques aimed at enhancing nipple prominence. The majority of studies have been based on relatively few patients (e.g.…”

Section: Introductionmentioning

confidence: 99%

Quantification of nipple size and shape among an ethnically diverse sample of US women

Woolridge,

Wildfeuer,

Alban

et al. 2023

Academia Medicine

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Research aim: to quantify nipple shapes and sizes in an ethnically diverse convenience sample of US women. A total of 510 women were recruited into this study-using an iPhone App, employing the 'True Depth Scanning' software, and scanning their torso from both the left and right aspect to secure an image of each breast. They provided 1,129 scans, of which 835 (74%) were submitted to a purpose-built algorithm which isolated the nipple-areola complex as a definable 3D cube, which was re-aligned to enable key parameters of nipple geometry to be measured. Viable data were secured from 78% of the scans undertaken, yielding 538 datasets from 329 participants. Outcome: This is the largest study undertaken with a non-clinical, ethnically diverse population of women, employing a novel scanning process and applying a novel purpose-built algorithm-with a view to characterizing the shape and size of the nippleareola complex, by collecting normative data on nipple geometry.

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“…Areola reconstruction is often performed by grafting from the upper inner thigh or contralateral areola or alternatively by intradermal paramedical pigmentation [38]. In order to provide a color and produce a more realistic appearance,several authors reported that tattooing is the ideal technique among the areola reconstruction procedures [39 -41].…”

Section: Introductionmentioning

confidence: 99%

Areola Reconstruction: Principles and Techniques

Simonacci¹,

Bertozzi²,

Pesce³

et al. 2018

MEDJ

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At the end of breast reconstruction, the creation of a natural-appearing areola is very important for patient satisfaction with the surgical result. The challenging aspects of achieving this include matching the color and texture as well as the size, shape, position, and projection of a normal areola, particularly in unilateral cases. The most common techniques that have been used to create a naturalistic nipple–areola complex have included skin grafting, tattooing, or a combination of both. Surgeons are finding that tattooing, the intradermal electric deposition of pigments, can be used to closely approximate natural areola pigmentation. Using the appropriate technique is essential as it is known that tattoo pigment fades over time and appears somewhat different after intradermal applied. Indeed, physicians’ experience and color selection greatly affect the aesthetic outcome. Skin grafting has long been used in nipple–areola reconstruction, and skin donor sites such as retro- auricular, inner thigh, labia minora and contralateral areola have been employed. The choice of donor site depends on different factors, including the presence of a healthy contralateral areola and the skin tone of the patient. In some cases, tattooing may be used in conjunction with grafting. Regardless of areolar reconstructive technique, medical pigmentation is becoming a preferred method of producing a more realistic-appearing breast, although periodic touch-ups may be required for optimal results.

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The optimal reconstruction size of nipple-areola complex following breast implant in breast cancer patients

Cited by 6 publications

References 18 publications

Guiding Nipple-Areola Complex Reconstruction: Literature Review and Proposal of a New Decision-Making Algorithm

Guiding Nipple-Areola Complex Reconstruction: Literature Review and Proposal of a New Decision-Making Algorithm

Quantification of nipple size and shape among an ethnically diverse sample of US women

Areola Reconstruction: Principles and Techniques

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