Areolar Tattoo Research Articles

Factors influencing final rendering in areola tattoo reconstruction: a statistical analysis.

Reconstruction of the nipple-areola complex announces the end of breast reconstruction process, sometimes difficult to live for the patient, and significantly improves the perception of body image. In literature there are no studies addressing the possible influencing factors of the final rendering of areola reconstruction with tattoo. The aim of the present study was to evaluate all the factors which could influence the yield and the final result of the nipple areola complex pigmentation. 97 patients who underwent areolar tattooing between January 2018 and February 2020 were retrospectively reviewed. Breast reconstruction timing and personal history, as well as surgical details were recorded. Mean age was 52 years old (range 29-71), almost the totality of cases was women including even 2 men (one with Poland syndrome and one post mastectomy). 27 patients needed bilateral tattooing. 22 had history of adjuvant radiotherapy, 16 received neoadjuvant chemotherapy and 4 adjuvant chemotherapy. In the logistic regression analysis, radiotherapy resulted a risk factor for retattooing (p<0.05) while the autologous breast reconstruction resulted a protective factor for retattooing. Neo - and adjuvant chemotherapy were not statistically significant. Tissue thickness, sex, reconstructive technique and history of radiotherapy could influence the final result in areola reconstruction with tattoo, and must be taken into account to obtain the best result, knowing when the pigmentation has to be repeated.

Abstract PO-128: Completion of nipple reconstruction in triple-negative breast cancer patients compared to triple-positive breast cancer patients: A single institutional analysis

Abstract Background: Triple-negative (TN) breast cancer is considered to be more aggressive than other subtypes of breast cancer and has a poorer prognosis. It is defined as breast cancer tumors that lack estrogen receptor (ER), progesterone receptor (PR), and HER2 expression and affects 17-20% of women with breast cancer. However, reconstructive outcomes remain to be elucidated when compared to other invasive breast cancer subtypes. The aim of this study is to determine if there is a disparity in completing nipple-areolar reconstruction in breast cancer patients with a triple-negative subtype compared to patients with a triple-positive (TP) subtype. Methods: 107 patients who underwent bilateral non-nipple sparing mastectomies from 2013 to 2017 diagnosed with a TN (n = 54) and TP (n = 53) invasive breast cancer subtype were identified. All 107 patients were seen by two attending surgeons at a single institution. Completion of nipple reconstruction and areolar tattoos, number of days from mastectomy to nipple reconstruction, and areolar tattoos were analyzed. Demographic/clinical variables, including race, age, BMI, smoking, comorbidities, neoadjuvant/adjuvant chemotherapy, hormonal therapy, radiation therapy, and choice of implants or flaps were also analyzed. Results: There was no significant difference in the proportion of patients who underwent radiation therapy in the TN group than in the TP group (55.56% vs 37.74%, p = 0.0819). Among these two groups, there was no significant difference in the percentage of patients completing nipple reconstruction (TN = 44.44%, TP = 49.06%, p = 0.7001) and acquiring an areolar tattoo (TN = 33.33%, TP = 39.62%, p = 0.5503). The differences in the average duration in days from mastectomy to nipple reconstruction (TN = 505.7, TP = 456.4, p = 0.5259) and areolar tattoos (TN = 665.6, TP = 638.5, p = 0.7653) among these two patient populations were also insignificant. Conclusion: TN subtype does not make a significant impact on completing nipple reconstruction when compared to TP patients, another extreme. These results should be considered when counseling TN patients on their reconstructive journey. Citation Format: Joshua Amaya, Kaitlin Jones, Nicholas T. Haddock, Sumeet S. Teotia. Completion of nipple reconstruction in triple-negative breast cancer patients compared to triple-positive breast cancer patients: A single institutional analysis [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-128.

Risk and protective factors affecting sensory recovery after breast reconstruction.

BackgroundAlthough loss of sensation in patients with breast cancer after mastectomy followed by breast reconstruction is an important factor affecting patients’ quality of life, the mechanism of sensory recovery is still unclear. Our study aimed to identify variables that affect sensory recovery, especially pain, in reconstructed breasts.MethodsAll patients with breast cancer who underwent mastectomy followed by immediate breast reconstruction, including nipple reconstruction or areolar tattooing, were included in this study. Sensation was evaluated in the nipple as an endpoint of sensation recovery of the whole breast. Patients rated pain severity using a 3-point verbal rating scale (VRS): grade 0, no pain; grade 1, mild to moderate pain; and grade 2, severe pain. The VRS was assessed by a single experienced plastic surgeon.ResultsIn the univariate analysis, the odds ratio (OR) for sensation recovery was 0.951 for age (P=0.014), 0.803 for body mass index (P=0.001), 0.996 for breast volume before surgery (P=0.001), 0.998 for specimen weight after mastectomy (P=0.040), and 1.066 for the period between mastectomy and sensory assessment (P=0.003). In the multivariate analysis, the variables that showed a significant effect were age (OR, 0.953; P=0.034), the period between mastectomy and sensory assessment (OR, 1.071; P=0.006), and reconstruction using abdominal tissue instead of prosthetic reconstruction (OR, 0.270; P=0.004).ConclusionsBased on our results, it can be inferred that aging has a negative impact on the recovery of sensation, breast sensation improves with time after surgery, and the recovery of sensation is better in prosthetic reconstruction.

3D Nipple–Areolar Tattoo: It’s Technique, Outcomes, and Utilization

Three-dimensional (3D) nipple-areolar tattoo is a novel approach to nipple-areolar complex reconstruction for which little data exist. Our aim was to evaluate 3D nipple-areolar tattoo outcomes and investigate if patient factors, payer status, surgeries, or therapies affect tattoo utilization. Patients pursuing skin-sparing (SSM) or attempted nipple-sparing mastectomy (NSM) with breast reconstruction from 2008 to 2019 were reviewed. Outcomes included frequency of 3D tattoo, post-procedure complications (infections, or other local adverse sequelae), and rates, indications, and timing of revisions. Patient factors, payer status, surgeries, and adjuvant therapies underwent univariate analysis comparing rates of 3D tattoo and revisions. A total of 191 patients were identified; median follow-up was 4years. The majority of patients were white (165, 86%), married (146, 76%), and post-menopausal (97, 51%), with private insurance (156, 81%). Surgeries included SSM (172, 90%) or attempted NSM (19, 10%) with implant (154, 81%) or autologous reconstruction (37, 19%). Sixty-two patients (32%) underwent 3D nipple-areolar tattooing. No post-procedure complications occurred. After tattooing, 20 patients (32%) pursued revisions, the majority due to color fading (12, 60%). Average time from tattoo to completion of revisions was 5.6months. Patients undergoing autologous reconstruction had a higher rate of 3D tattooing (p < 0.001). Adjuvant radiation led to a higher rate of revisions (p = 0.02). Patient factors, payer status, index mastectomy, and chemotherapy did not significantly affect rates of 3D tattooing or revisions. 3D nipple-areolar tattoo utilization is likely unaffected by age, marriage, menopause, or payer status. Radiotherapy and color fading can lead to more revisions. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

La reconstruction de l’aréole et du mamelon

The reconstruction of the nipple-areolar complex is the final stage of breast reconstruction that restores the visual identity of the breast. The most common options for reshaping the areola are tattooing, total skin grafting of the inner thigh and the total skin graft taken from the contralateral areola. Nipple reconstruction solutions include duplication of contralateral nipple, local flap, total skin graft and tattoo in three-dimension. Duplication of the nipple is the technique of choice because it immediately offers optimal color, texture and projection. The areolar tattoo is the most common procedure for its simplicity and reproducibility.

Emotional healing with unconventional breast tattoos: The role of temporary tattoos in the recovery process after breast carcinoma and mastectomy

The healing process after breast cancer treatment is predominantly focused toward the physical changes to the body that a patient has experienced. Breast reconstructions are considered standard of care after mastectomy, and the nipple and areolar complex is often reconstructed as well, using a combination of skin graft and tattoo. A patient who decided to forego nipple reconstruction and areolar tattooing and instead chooses to apply decorative temporary tattoos to her breast reconstruction is described. Compared with permanent tattoos, these unconventional tattoos allow the patient to change the design to fit her mood. Unconventional tattoos are an alternative and creative approach to the healing process, in which artistic and individual expression allows the patient to embrace the physical change she has undergone as a breast cancer survivor.

C-Y Trilobed Flap for Improved Nipple-Areola Complex Reconstruction.

Nipple-areola complex reconstruction has been shown to improve breast reconstruction patients' overall satisfaction. Trilobed flap variations are some of the more commonly used flaps for nipple-areola complex reconstruction. The donor-site scar frequently extends outside the width of an ideal areolar tattoo diameter. There have been many modifications to the original flap design, but none of them addresses the length of the donor-site scar. The technique described uses a triangular stitch in the donor site to limit the length of the scar. This also creates tiny dog-ears within the future areola zone that give a natural wrinkled appearance when tattooed.

Breast Amputation Correction of a Horse Bite Using the Lipomodeling Technique

Mammary gland development is an important phase of puberty, and it marks the passage into adulthood for women, so any trauma leading to mammary deformities has an important physical and psychological impact. Often, classic techniques are difficult to use in the treatment of traumatic breast lesions. In this article, the authors present an exceptional case of breast reshaping by lipomodeling in a teenage patient who had experienced a horse bite. Treatment included 2 fat grafting sessions with fasciotomies, nipple reconstruction using a bifoliated flap, and areolar tattooing, all without any complications. We achieved a satisfactory result with a symmetric volume, a natural tissue consistency, and sensation improvement, all of which were maintained as the patient grew. In our experience, fat transfer was a safe and reliable technique that provided a good and stable aesthetic result, improving the volume and shape without additional scarring or implant devices. 5.

Técnica simples e segura para a reconstrução areolopapilar com tatuagem intradérmica

INTRODUÇÃO: A reconstrução do complexo areolopapilar (CAP) constitui o passo final na criação da neomama, com o objetivo de aproximá-la da mama contralateral após a mastectomia. A restauração do CAP tem sido historicamente um procedimento feito em estágios, com a reconstrução da papila realizada por meio de enxertos ou retalhos locais, previamente, e da aréola, posteriormente, buscando a coloração adequada. Atualmente, a utilização da tatuagem areolar está alcançando popularidade cada vez maior, comparativamente às técnicas tradicionais. O objetivo deste trabalho é descrever a técnica e os equipamentos utilizados para a tatuagem intradérmica em pacientes mastectomizadas, realizada no Serviço de Cirurgia Plástica e Microcirurgia Reconstrutiva do Hospital Universitário Walter Cantídio (Fortaleza, CE, Brasil). MÉTODO: O presente trabalho descreve os passos para a realização do procedimento reparador utilizando a tatuagem areolar permanente com equipamento convencional de tatuagem artística profissional. O procedimento foi aplicado em 10 pacientes submetidas a reconstrução mamária pós-mastectomia. RESULTADOS: O método demonstrou as vantagens da simplicidade técnica do procedimento, não requerendo internamento nem resultando em morbidade de áreas doadoras. CONCLUSÕES: A tatuagem do CAP é um procedimento seguro, rápido, com baixa morbidade e bons resultados na finalização da reconstrução mamária.

Immediate Nipple Reconstruction on a Free TRAM Flap Breast Reconstruction

Reconstruction of the nipple-areola complex is usually deferred until breast mound reconstruction is complete. The authors review their experience with a technique that allows for shaping of a free transverse rectus abdominis myocutaneous (TRAM) flap and immediate nipple reconstruction and compare this technique with delayed nipple reconstruction. A retrospective chart review demonstrated 21 patients who underwent immediate nipple reconstruction, 10 of whom had complete photographs and records for review. Ninety patients underwent delayed nipple reconstruction. Twenty of these patients were chosen for comparison, 15 of whom had complete photographs and records. Age, body mass index, comorbidities, procedures required, complications, and time to completion were reviewed. A multiobserver, multicharacteristic, standardized photographic review of cosmetic outcomes was conducted. Time from mastectomy to completion of reconstruction, not including areolar tattooing, was 1 day (median) versus 125 days (median) in the immediate and delayed groups, respectively (p = 0.003). The number of procedures required to complete reconstruction before areolar tattooing was one (median) in the immediate group and two (median) in the delayed group (p < 0.001). Complication rates were similar in both groups. Subjective review demonstrated no difference in the aesthetic outcome of the breast mound or nipple-areola complex reconstruction. Patients having immediate nipple reconstruction in the setting of a free TRAM breast reconstruction completed their reconstruction earlier, required fewer procedures, and had aesthetic results comparable to patients having traditional delayed nipple reconstruction. Complications and revision rates were comparable.