The optimal reconstruction size of nipple-areola complex following breast implant in breast cancer patients.

Naoki Hayashi,Yoshiko Iwahira,Osamu Takahashi,Takako Komiya,Naomi Nagura-Inomata

doi:10.1186/s40064-016-2230-5

Abstract

BackgroundChanges in the areola size after reconstruction of the nipple-areola complex (NAC) following mastectomy and breast reconstruction with a silicon implant in primary breast cancer patients have not been well examined. This study aimed to investigate time-dependent changes in the size of the donor and graft NACs and to assess clinical factors influencing these changes.MethodsFifty-eight consecutive patients who underwent nipple-areola reconstruction were retrospectively evaluated. Nipple-areola diameter was measured immediately after the NAC reconstruction and at each follow-up visit for at least 36 months.ResultsThe donor NAC constituted 81 % of the graft NAC at the time of operation. The size of the donor NAC gradually increased by up to 36.8 % after the operation. The size of the graft NAC showed a decrease by 4.5 % at 7 months, followed by recovery to the initial value. The ratio of the donor site size to the graft site size was increased at month 1 and then showed a gradual decrease to 1.08 at 36 months. A history of mastopexy or reduction for the donor site was independent factors associated with changes in the NAC size.ConclusionsTo achieve symmetry, the diameter of the donor NAC immediately after the reconstruction should be at least 20 % smaller than that of the graft NAC, especially for patients without a history of additional operations.

Highlights

Changes in the areola size after reconstruction of the nipple-areola complex (NAC) following mastec‐ tomy and breast reconstruction with a silicon implant in primary breast cancer patients have not been well examined
We first assessed the changes in the NAC size of both donor and graft sites in patients who had undergone nipple-areola reconstruction using a full-thickness skin graft from the contralateral areola following mastectomy with breast reconstruction
Time‐dependent changes in the NAC size The size of the donor NAC increased by up to 31.1 % compared to the initial size at 1 month after the reconstruction and by up to 43.7 % at 36 months in the horizontal direction

Summary

Introduction

Changes in the areola size after reconstruction of the nipple-areola complex (NAC) following mastec‐ tomy and breast reconstruction with a silicon implant in primary breast cancer patients have not been well examined. This study aimed to investigate time-dependent changes in the size of the donor and graft NACs and to assess clinical factors influencing these changes. Reconstruction of the nipple-areola complex (NAC) completes the final aesthetical step of breast reconstruction and restores the body image of breast cancer patients who have undergone mastectomy. We first assessed the changes in the NAC size of both donor and graft sites in patients who had undergone nipple-areola reconstruction using a full-thickness skin graft from the contralateral areola following mastectomy with breast reconstruction. We sought to identify clinical factors influencing the size of the NAC by comparing several parameters in different groups of patients

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