Abstract
Background
Nipple reconstruction is usually performed as a separate procedure, several months after the primary breast reconstruction. This study compared the outcomes of immediate and delayed nipple reconstructions during implant-based breast reconstructions.
Methods
A retrospective review was conducted of patients who underwent nipple reconstruction, after implant-based breast reconstruction, between September 2014 and August 2015. The nipple was simultaneously reconstructed following tissue expander removal and implant placement. The reconstructed nipple was evaluated immediately after surgery and 1 year later using objective measurements of nipple dimension and position, and a subjective assessment.
Results
Sixty-one patients were included in the study, undergoing either immediate (n = 37) or delayed (n = 24) nipple reconstructions. Patients undergoing immediate nipple reconstructions had a significantly lower chance of radiotherapy (p = 0.018) and demonstrated a shorter period of tissue expansion (p = 0.011) than those undergoing delayed reconstructions. In the objective evaluations, nipple projections and symmetries between the groups were similar at the 1-year postoperative assessment. In the subjective reviews, esthetic breast mound outcomes were higher among those undergoing immediate reconstructions than among those undergoing delayed reconstructions; similar nipple symmetry and shape outcomes were obtained for both groups.
Conclusion
In cases of implant-based breast reconstruction, immediate nipple reconstruction concurrent with breast reconstruction provides satisfactory esthetic results compared with conventional delayed nipple reconstruction, in properly selected patients.
Level of evidence IV
This journal requires that authors assign a level of evidence to each article. 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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Zhong T, Antony A, Cordeiro P (2009) Surgical outcomes and nipple projection using the modified skate flap for nipple-areolar reconstruction in a series of 422 implant reconstructions. Ann Plast Surg 62:591–595
Losken A, Mackay GJ, Bostwick J 3rd (2001) Nipple reconstruction using the C-V flap technique: a long-term evaluation. Plast Reconstr Surg 108:361–369
Kim HR, Lim JS, Kim SM, Jung SN, Yoo G, Rha EY (2013) One-stage nipple and breast reconstruction following areola-sparing mastectomy. Arch Plast Surg 40:553–558
Williams EH, Rosenberg LZ, Kolm P, de la Torre JI, Fix RJ (2007) Immediate nipple reconstruction on a free TRAM flap breast reconstruction. Plast Reconstr Surg 120:1115–1124
Hyza P, Streit L, Vesely J, Stafova D, Sin P (2015) New technique of immediate nipple reconstruction during immediate autologous DIEP or MS-TRAM breast reconstruction. Ann Plast Surg 74:645–651
Craig ES, Walker ME, Salomon J, Fusi S (2013) Immediate nipple reconstruction utilizing the DIEP flap in areola-sparing mastectomy. Microsurgery 33:125–129
Delay E, Mojallal A, Vasseur C, Delaporte T (2006) Immediate nipple reconstruction during immediate autologous latissimus breast reconstruction. Plast Reconstr Surg 118:1303–1312
Lee JH, Park KR, Kim TG, Ha JH, Chung KJ, Kim YH, Lee SJ, Kang SH (2013) A comparative study of CG CryoDerm and AlloDerm in direct-to-implant immediate breast reconstruction. Arch Plast Surg 40:374–379
Kim YE, Hong KY, Minn KW, Jin US (2016) A novel nipple reconstruction technique for maintaining nipple projection: the boomerang flap. Arch Plast Surg 43:470–473
Khan HA, Bayat A (2008) A geometric method for nipple localization. Can J Plast Surg 16:45–47
Carlson GW, Bostwick J 3rd, Styblo TM, Moore B, Bried JT, Murray DR, Wood WC (1997) Skin-sparing mastectomy. Oncologic and reconstructive considerations. Ann Surg 225:570–575 (discussion 575–578)
Kroll SS, Schusterman MA, Tadjalli HE, Singletary SE, Ames FC (1997) Risk of recurrence after treatment of early breast cancer with skin-sparing mastectomy. Ann Surg Oncol 4:193–197
Toth BA, Forley BG, Calabria R (1999) Retrospective study of the skin-sparing mastectomy in breast reconstruction. Plast Reconstr Surg 104:77–84
Di Benedetto G, Sperti V, Pierangeli M, Bertani A (2004) A simple and reliable method of nipple reconstruction using a spiral flap made of residual scar tissue. Plast Reconstr Surg 114:158–161
Shestak KC, Gabriel A, Landecker A, Peters S, Shestak A, Kim J (2002) Assessment of long-term nipple projection: a comparison of three techniques. Plast Reconstr Surg 110:780–786
Acknowledgments
The authors have no financial or institutional interest in any of the drugs, materials, or devices described in this article.
Author information
Authors and Affiliations
Corresponding author
Additional information
Ki Yong Hong and Young-Eun Kim contributed equally to this work.
Rights and permissions
About this article
Cite this article
Hong, K.Y., Kim, YE., Minn, K.W. et al. Immediate Nipple Reconstruction During Implant-Based Breast Reconstruction. Aesth Plast Surg 41, 793–799 (2017). https://doi.org/10.1007/s00266-017-0804-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-017-0804-4