Prosthetic nipple areola complex reconstruction after breast reduction: a case report

Total nipple-areola necrosis following breast reduction is a rare and unfortunate event. Several causes may be responsible for it, including compression of the vascular pedicle, venous congestion, infection, hematoma, or inappropriate surgical technique. Considering the importance of the nipple areola complex (NAC) in the overall appearance of a breast mound, it is clear that the complete loss of the nipple areola complex is one of the most traumatizing complications for both the patient and the surgeon. Herein we describe the case of a patient who developed complete NAC necrosis following breast reduction. After initial wound management and stabilization, the patient underwent delayed reconstruction using an innovative NAC implant specifically designed to restore nipple projection and contour. Delayed reconstruction of the left NAC was performed using a silicone implant (FixNip, GC Aesthetics, Caesarea, Israel), specifically designed to restore natural projection and contour. The implant was positioned under local anesthesia as an outpatient procedure. Postoperative course was uneventful. At 8 months, after ultrasound confirmed proper implant integration, medical tattooing of the areola was completed. Implant based NAC reconstruction achieved a stable and well-projected NAC reconstruction. No minor or major complications occurred, and the patient reported high satisfaction with the aesthetic result and psychological benefit from restoration of breast harmony. To our knowledge, this is the first described case demonstrating a successful implant-based NAC reconstruction following total necrosis after breast reduction. The FixNip implant, combined with medical tattooing, provided a safe and reliable solution with excellent cosmetic outcomes.