Patient satisfaction following nipple-areolar complex reconstruction and tattooing

Goh, Steven; Martin, Neil A.; Pandya, Aditya; Cutress, Ramsey I.

doi:10.1016/j.bjps.2010.05.010

Cited by 81 publications

(67 citation statements)

References 10 publications

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“…[49][50][51] The ideal nipple reconstruction should be symmetrical in shape, site, size, texture, and pigmentation. The procedure is often delayed until three to four months after reconstruction of the breast mound.…”

Section: What Secondary Procedures Might Be Necessary After Breast Rementioning

confidence: 99%

Post-mastectomy breast reconstruction

Thiruchelvam

McNeill

Jallali

et al. 2013

BMJ

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tion options with patients, irrespective of whether they are available locally. 6 Fifty three per cent of women having surgery for breast cancer will undergo mastectomy (box 1). 7 8 In the UK and United States, bilateral mastectomy is increasingly being used for risk reduction in BRCA carriers, for those with a high risk of developing breast cancer (lifetime risk of 30%), or as a planned management strategy for unilateral cancer (fig 1, bmj.com). 9-15 In general, bilateral mastectomy is associated with a higher rate of breast reconstruction. A recent Cochrane review showed that bilateral prophylactic (risk reduction) mastectomy reduced the incidence of, and death from, breast cancer, but it highlighted that more rigorous prospective studies are needed to assess absolute risk reduction. 16 The review also found that although contralateral prophylactic (risk reduction) mastectomy decreases the incidence of cancer in the contralateral breast, it is unclear whether, and for whom, this practice improves survival. 16 How is a mastectomy performed?When performing a mastectomy, the anatomical (oncological) plane between breast tissue and subcutaneous fat needs to be identified. It is, however, impossible to remove all breast tissue because the oncological plane is not uniform throughout the breast. A standard (simple) mastectomy removes the breast skin envelope, but a skin sparing mastectomy preserves the breast skin envelope Breast cancer is the most common cancer in women, with almost 1.38 million new cases a year worldwide; it accounts for 23% of all cancers and 14% of deaths from cancer. 1 However, mortality from breast cancer is d eclining-increasing numbers of women are long term survivors (>5 years) (currently 549 000 in the United K ingdom). 2 3 Surgery remains a mainstay of treatment, either breast conservation or mastectomy, but any breast surgery can greatly alter breast aesthetics and body image.Breast reconstruction restores breast symmetry after a mastectomy by creating a breast mound, similar in size, shape, contour, and "out of bra position" to the contralateral breast. In England and Wales in 2002, about 10% of women had immediate breast reconstruction; by 2009 this had risen to 21%. 4 Post-mastectomy breast reconstruction is associated with improved body image, quality of life, self confidence, and wellbeing. 5 In this review, we outline the indications for breast reconstruction along with the timing and techniques available to patients after mastectomy. What is post-mastectomy breast reconstruction?Breast reconstruction is a surgical procedure that restores shape to the breast after mastectomy. Although it will not re-create the exact look and feel of a natural breast, it aims to create a breast mound contour similar to that before mastectomy. When, and to whom, should breast reconstruction be offered?In 2009 the National Institute for Health and Clinical Excellence (NICE) revised guidance on improving breast cancer outcomes. It recommended discussing immediate reconstruction with all patients ha...

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Section: What Secondary Procedures Might Be Necessary After Breast Rementioning

confidence: 99%

Post-mastectomy breast reconstruction

Thiruchelvam

McNeill

Jallali

et al. 2013

BMJ

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“…3,16 Although tattooing conveniently produces a pigmented skin, fading is expected. Re-tattooing is easy and causes minimal inconvenience.…”

Section: Discussionmentioning

confidence: 99%

A New Local Flap Nipple Reconstruction Technique Using Dermal Bridge and Preoperatively Designed Tattoo

Komiya

Iwahira

2017

Plastic and Reconstructive Surgery - Global Open

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“…NAC reconstruction can result in asymmetry with the contralateral NAC, decreased nipple projection, nipple loss, and unsatisfactory results involving color (depigmentation), size, position, and diminished or absent sensation. Research has demonstrated that patients who undergo NAC preservation report enhanced body image, psychological adjustment, and overall satisfaction compared to women who underwent mastectomy without nipple preservation (Chen et al, 2009;Billar, Dueck, Gray, Wasif, & Pockaj, 2011;Wellisch, Schain, Noone, & Little, 1987;Goh, Martin, Pandya, & Cutress, 2011). In Djohan et al's eight year outcome study surveying patients who underwent NSM with immediate reconstruction, a majority of patients rated appearance, symmetry, color, position, and texture as good or excellent, and 73.1% of responders stated they would definitely undergo NSM again (Djohan et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Nipple-Sparing Mastectomy via Inframammary Fold: Reconstructive Red Flags

Mahmood¹,

Suber²,

Zadikany³

et al. 2016

CCO

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Background: Nipple-sparing mastectomy (NSM) is a technically feasible and oncologically sound option for patients who meet eligibility criteria. Inframammary fold (IMF) incision results in a well-hidden scar and enhanced final aesthetic result. While oncologic eligibility criteria have been well established, reconstructive criteria are less defined. We report Moffitt Cancer Center's (MCC) outcomes with IMF incision for NSM and immediate reconstruction, and factors associated with increased complication rate.Methods: IRB approved retrospective cohort study of patients who underwent NSM through an IMF approach with immediate reconstruction at MCC from 2006-2013 was conducted. Analysis included patient demographics, tumor characteristics, ancillary treatment, reconstructive method, and nipple and skin flap necrosis. A literature review was performed to compare outcomes with other types of incisions.Results: 115 patients met inclusion criteria, representing 199 breasts. The average age was 48.1 (range 18-74). The two main complication categories evaluated were nipple necrosis (8%) and skin flap necrosis (10.6%). Older age demonstrated a significant relationship with skin flap necrosis (p=0.0155) and overall complications (p=0.0492). Complication rate was significantly higher in the cancer side vs. prophylactic side in patients who underwent bilateral mastectomies (p=0.0088). Factors with trends related to increased skin flap necrosis included increased mastectomy specimen weight (p=0.0704), smoking (p=0.0726), and significant comorbidities (p=0.0665).Conclusion: Our institution's results substantiate that NSM through an IMF approach with immediate reconstruction is a viable option. Recognized risk factors such as age, laterality, breast weight, smoking history, and comorbidities associated with increased complications should be considered when determining patient selection for reconstruction.

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Patient satisfaction following nipple-areolar complex reconstruction and tattooing

Cited by 81 publications

References 10 publications

Post-mastectomy breast reconstruction

Post-mastectomy breast reconstruction

A New Local Flap Nipple Reconstruction Technique Using Dermal Bridge and Preoperatively Designed Tattoo

Nipple-Sparing Mastectomy via Inframammary Fold: Reconstructive Red Flags

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