Single-Stage Nipple-Areolar Complex Reconstruction

Abstract

Nipple-areolar complex (NAC) reconstruction is an essential final step in the completion of the breast reconstructive process. Many techniques to achieve satisfactory appearance of the reconstructed NAC have been described (Yang et al., Arch Plast Surg 41:550–555, 2014; Weinfeld et al., Ann Plast Surg 61:364–367, 2008; Sisti et al., Eur J Surg Oncol 42:441–465, 2016). Most require two stages: one to complete the creation of a three-dimensional nipple construct and another to achieve pigmentation of the nipple and areola. Prior studies indicate that increased duration of reconstruction decreases patient satisfaction (Jabor et al., Plast Reconstr Surg 110:457–463, 2002: Losken et al., Plast Reconstr Surg 108:361-369, 2001). Although several techniques exist, a single-stage nipple-areolar complex reconstruction (SS NAR) technique achieves a natural-appearing NAC in a single procedure which entails medical pigmentation and creation of a nipple construct in one setting. This unique technique of reconstruction yields adequate nipple projection, uniform dye uptake, excellent symmetry, and low complication rates. SS NAR is an effective, reliable, and reproducible technique to create a natural-appearing NAC. Nipple-areolar reconstruction (NAR) and medical pigmentation in one stage confer the benefit of a shorter time to completion of the breast reconstructive process and are associated with a high degree of patient satisfaction.