Nipple-areola complex reconstruction techniques: A literature review

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncology

Background:

• Nipple-areola complex (NAC) reconstruction is a crucial component of breast reconstruction.
• Numerous techniques exist, but a clear overview of their efficacy and complication rates is needed.

Purpose of the Study:

• To provide a comprehensive literature overview of NAC reconstruction techniques.
• To compare complication rates and outcomes of different nipple and areola reconstruction methods.

Main Methods:

• A literature review of 75 papers published between 1946 and 2015.
• Analysis of complication rates for various nipple reconstruction techniques (graft, local flap, flap with augmentation) and areola reconstruction techniques (graft, tattoo).

Main Results:

• Local flaps were the most frequent nipple reconstruction technique with a low complication rate (7.9%).
• Grafts had higher complication rates for both nipple (46.9%) and areola (10.1%) reconstruction.
• Areola tattoo (1.6%) was safer than grafts, and flaps with augmentation showed minor projection loss but increased flap necrosis risk.

Conclusions:

• Local flaps are more reliable for nipple reconstruction than grafts.
• Tattooing is a safer option for areola reconstruction compared to grafting.
• While projection loss is common, it does not significantly impact patient satisfaction; overcorrection may be advised for local flaps.