Current strategies for the reconstruction of the nipple-areola complex: a review

Alondra Mendizabal-Velazquez; Juan José Granados-Romero; Jorge Montalvo-Hernández; Juan C. Vázquez-González; Patricia M. Palacios-Rodríguez; Itaty C. González-Martínez; Nicolás R. Brito-Brito; Ana L. Abundez-Pliego; Alan I. Valderrama-Treviño; Baltazar Barrera-Mera

doi:10.18203/2320-6012.ijrms20232479

Authors

Alondra Mendizabal-Velazquez Department of Physiology, Faculty of Medicine. UNAM, Mexico
Juan José Granados-Romero Department of General Surgery, General Hospital of Mexico Dr. Eduardo Liceaga, CDMX, Mexico
Jorge Montalvo-Hernández Department of Surgery, Endocrine and Advanced Laparoscopic Surgery Service, North Central Hospital PEMEX, Mexico City, Mexico
Juan C. Vázquez-González Department of General Surgery, General Hospital of Mexico Dr. Eduardo Liceaga, CDMX, Mexico
Patricia M. Palacios-Rodríguez Department of Pediatrics, General Hospital of Mexico, Dr. Eduardo Liceaga, CDMX, Mexico
Itaty C. González-Martínez Department of Pediatrics, General Hospital of Mexico, Dr. Eduardo Liceaga, CDMX, Mexico
Nicolás R. Brito-Brito Department of General Surgery, General Hospital of Mexico Dr. Eduardo Liceaga, CDMX, Mexico
Ana L. Abundez-Pliego Department of Angiology, Vascular and Endovascular Surgery, General Hospital of Mexico, Dr. Eduardo Liceaga, CDMX, Mexico
Alan I. Valderrama-Treviño Department of Surgery, PEMEX General Hospital, Ciudad del Carmen, Mexico
Baltazar Barrera-Mera Department of Physiology, Faculty of Medicine. UNAM, Mexico

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232479

Keywords:

Nipple-areola complex, Mastectomy, Local flap, Autologous graft, 3D tattoos], Tissue engineering

Abstract

The reconstruction of the nipple-areola complex after a mastectomy is essential for the bio-psycho-social recovery of the patient, it is generally performed 4 to 6 months after surgery and there are multiple surgical reconstruction techniques depending on the experience of the surgeon and of the individual characteristics of the patients. The most widely used for its safety and for having shown the best results is the local flap technique combined with the use of autologous, alloplastic and allograft grafts. However, currently there is still no technique that shows long-term lasting results. For this reason, in this article we describe the five categories of reconstruction techniques for the nipple-areola complex that currently exist, their advantages and disadvantages, as well as the lines of research in tissue engineering in which the world is working to find a therapeutic strategy that can reproduce a nipple-areola complex with the characteristics of the biologic.

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References

Andrea S. Nipple-Areola Complex Reconstruction. Medicina (Kaunas). 2020;16;56(6):296.

Seki H, Sakurai T, Mizuno S, Tokuda T, Kaburagi T, Seki M. A novel nipple–areola complex involvement predictive index for indicating nipple-sparing mastectomy in breast cancer patients. Breast Cancer. 2019;26:808-16.

Gougoutas A, Said H, Um G, Chapin A, Mathes D. Nipple-Areola Complex Reconstruction. PRS J. 2018;141:404-16.

Nimboriboonporn A, Chuthapisith S. Nipple-areola complex reconstruction. Gland Surg. 2014;3(1):35-42.

Farhadi J, Maksvytyte GK, Schaefer DJ, Pierer G, Scheufler O. Reconstruction of the nipple-areola complex: an update. J Plast Reconstr Aesthet Surg. 2006;59(1):40-53.

Boccola MA, Savage J, Rozen WM, Ashton MW, Milner C, Rahdon R, Whitaker IS. Surgical correction and reconstruction of the nipple-areola complex: current review of techniques. J Reconstr Microsurg. 2010;26(9):589-600.

Darrach H, Kokosis G, Bridgham K, Stone JP, Lange JR, Sacks JM. Comparison of keystone flaps and skin grafts for oncologic reconstruction. A retrospective review. J Surg Oncol. 2019;119:843-9.

Guido Paolini, Guido Firmani, Francesca Briganti, Michail Sorotos, Fabio Santanelli di Pompeo. Guiding Nipple-Areola Complex Reconstruction: Literature Review and Proposal of a New Decision-Making Algorithm. Springer Nature. 2021;45:933-45.

Kuruvilla AS, Gopman JM, Cham S, Henderson PW. Nipple-areolar tattoo. Comprehensive review of history, theory, technique, and outcomes. J Plast Reconstr Aesthet Surg. 2022;75:544-9.

Caroline J, Rachael L. Evolution of Operative Technique for Mastectomy. Surgical Clinics of North America. 2018;98:835-44.

Dennis JH, Armando AD. Contemporary Management of Gynecomastia. Clin Plastic Surg. 2022;49:293-305.

Bhagwat Mathur, Charles Yuen Yung Loh. Sensation-Sparing Correction of Inverted Nipples Using the 'Drawbridge' Flap Approach. Aesthetic Plastic Surg. 2019;43:348-53.

Gerber B, Krause A, Reimer T. Skin-sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction is an oncologically safe procedure. Ann Surg. 2003;238:120-7.

Schwartz JD. Nipple-Areola Complex Reconstruction Using a Skin Graft and Nipple Sharing after Wise-pattern Central Lumpectomy. Plast Reconstr Surg Glob Open. 2021;9(4):e3539.

Cha HG, Kwon JG, Kim EK. Simultaneous Nipple-Areola Complex Reconstruction Technique: Combination Nipple Sharing and Tattooing. Aesthetic Plast Surg. 2019;43(1):76-82.

Heo JW, Park SO, Jin US. A Nipple-Areolar Complex Reconstruction in Implant-Based Breast Reconstruction Using a Local Flap and Full-Thickness Skin Graft. Aesthetic Plast Surg. 2018;42:1478-84.

Khoo D, Ung O, Blomberger D, Hutmacher DW. Nipple Reconstruction: A Regenerative Medicine Approach Using 3D-Printed Tissue Scaffolds. Tissue Eng Part B Rev. 2019;25(2):126-34.

Starnoni M, Baccarani A, Pinelli M, Pedone A, De Santis G. Tattooing of the nipple-areola complex: What not to do. A case series. Ann Med Surg (Lond). 2020;55:305-7.

Sisti A, Grimaldi L, Tassinari J, Cuomo R, Fortezza L, Bocchiotti MA. Nipple-areola complex reconstruction techniques: A literature review. Eur J Surg Oncol. 2016;42:441-65.

Zhu W, Ma X, Gou M, Mei D, Zhang K, Chen S. 3D printing of functional biomaterials for tissue engineering. Curr Opin Biotechnol. 2016;40:103-12.

Moroni S, Casettari L, Lamprou DA. 3D and 4D Printing in the Fight against Breast Cancer. Biosensors (Basel). 2022;12(8):568.

Samadi A, Premaratne ID, Wright MA. Nipple Engineering: Maintaining Nipple Geometry with Externally Scaffolded Processed Autologous Costal Cartilage. J Plast Reconstr Aesthet Surg. 2021;74(10):2596-603.