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Nipple-Areola Complex Replantation After Mastectomy and Immediate Breast Reconstruction

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Nipple-Areolar Complex Reconstruction

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Abstract

Traditionally, the nipple-areolar complex (NAC) is resected during mastectomy. The NAC determinates aesthetic outcome after breast reconstruction, and a natural-looking NAC can barely be reconstructed with other tissues. The aim was to assess the oncological safety as well as morbidity and aesthetic outcome after replantation of the NAC. Retrospective analysis of 85 patients receiving 88 mastectomies and IBR was conducted. NAC (n = 29) or the nipple alone (n = 23) was replanted 7 days (median, range 2–10 days) after IBR in 49 patients. Malignant involvement of the subareolar tissue was found in eight cases (9.1%). In 69% and 26% of the cases, total or partial necrosis occurred if the entire NAC or only the nipple were replanted, respectively (P <0.01). Depigmentation was seen in 52%, and corrective surgery was done in 11 out of 52 NAC or nipple replantations. Local recurrence and isolated regional lymph node metastasis were observed in one single case each. It can be concluded that the replantation of the NAC in IBR is oncologically safe. However, the long-term aesthetic outcome of NAC replantation is not satisfying, which advocates replanting the nipple alone.

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Authors and Affiliations

  1. WIRTH Plastische Chirurgie, General-Dufour-Str. 17, 2502, Biel-Bienne, Switzerland

    Raphael Wirth M.D.

  2. BANIC Plastische Chirurgie, Bundesgasse 26, 3011, Bern, Switzerland

    Andrej Banic M.D.

  3. Plastische Chirurgie Erni, Küferweg 9, 6403, Küssnacht am Rigi, Switzerland

    Dominique Erni M.D.

Authors
  1. Raphael Wirth M.D.
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  2. Andrej Banic M.D.
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  3. Dominique Erni M.D.
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Correspondence to Raphael Wirth M.D. .

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Editors and Affiliations

  1. Private Practice, Tustin, California, USA

    Melvin A. Shiffman

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© 2018 Springer International Publishing AG

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Wirth, R., Banic, A., Erni, D. (2018). Nipple-Areola Complex Replantation After Mastectomy and Immediate Breast Reconstruction. In: Shiffman, M. (eds) Nipple-Areolar Complex Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-319-60925-6_83

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  • DOI: https://doi.org/10.1007/978-3-319-60925-6_83

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60924-9

  • Online ISBN: 978-3-319-60925-6

  • eBook Packages: MedicineMedicine (R0)

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