These 913 items were reduced to 184 by combining redundant ideas. These items fit into 13 domains: preoperative expectations, complexity of reconstruction, breast issues, nipple concerns, arm concerns, clothing limitations, donor site problems, career/daily life effects, psychological effects, impact on relationships, self image, worries and overall satisfaction. Thus, a total of 913 potential items were identified. A further 227 items were gleaned from the literature review.
Another 171 items were generated from expert panelists. Focus group analysis generated an inventory of 515 items. There were 16 autologous and 11 alloplastic reconstructions 13 were unilateral, and 7 bilateral. There has been a practice shift toward tattoos that can be carried out either by the surgeon or by para-medical personnel.Īs with any surgery, it is important to discuss expectations with the patient prior to carrying nipple-areolar reconstructive surgery as this can impact on patient satisfaction.įour focus groups comprising 20 women were conducted at a range from 0.9 to 5.1 years post-surgery. Representative results as well as complications will be shown.Īreolar reconstruction may be accomplished by skin grafts, areola-share grafts, or tattoos. Technical details will be discussed, with accompanying potential advantages and disadvantages of each reconstructive option. The surgeon’s armamentarium for nipple reconstruction should include both local-flap reconstructions, with or without structural support, and composite graft techniques. Success can be optimized if the surgeon selects the type of nipple-areolar reconstruction that may be best-suited to the individual’s breast mound characteristics.įeatures of the breast mound that can impact on nipple outcome include history of radiotherapy, smoking status, positioning of scars, presence of skin laxity, and type of reconstruction. A poor outcome in nipple-areolar reconstruction can negatively impact the overall breast reconstruction. It not only takes the focus off the scars on the breast reconstruction, but transforms the mound into a breast.
Nipple-areolar reconstruction is the final stage in breast reconstructive surgery.
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