Objectives: The goal of this manuscript is to analyze the main NAC reconstruction techniques performed in a Brazilian reference center between 2017 and 2022, comparing outcomes and complications. Secondarily, we determine the epidemiological profile, the breast reconstruction techniques used and the surgical time for NAC reconstruction performed in this population.
Introduction: Reconstruction of the nipple-areola complex (NAC) is one of the surgeries that represents the rehabilitation of breast cancer patients. Several techniques have been described over the years aiming to reconstruct a NAC with a similar appearance of the original, mainly in relation to the projection of the papilla, shape, texture and color of the areola. This is typically accomplished with the use of local flaps and/or distant grafts options.
Materials / method: Epidemiological, observational and retrospective study performed in the Plastic Surgery Service of Hospital Federal de Ipanema from January 2017 to December 2022. The data was collected by electronic and physical records. A total of 15 NAC reconstructions were performed with equivalent laterality. The mean age was 53.73 years, 60% were health and 46.67% were overweight (BMI > 25). All patients undergoing total mastectomy electively due to breast neoplasia and 8, 5 and 2 patients had their breast reconstruction with breast implant, latissimus dorsi and rectus abdominis free flap, respectively.
Results: The NAC reconstructions occurred between the 3rd and 5th surgical time with an average of 30.53 months. Among the surgical techniques, the the most common was the contralateral nipple graft (60%), followed by the 'skate' technique (26.66%), the star technique (6.67%) and the cylinder technique (6.67%) associated with a skin flap from inguinal area. The majority (73.33%) did not have prior local radiotherapy. The overall complication rate was 13.5% ( local infection and partial necrosis) and only one patient required a new local approach (6.63%).
Conclusion: NAC reconstruction adds an important aesthetic and psychological point of view in the rehabilitation of patients. The majority of the sample underwent NAC reconstruction after 30 months of breast reconstruction using the contralateral nipple graft technique associated with a skin flap from the inguinal donor area. There was a low complication and re-approach rate. The satisfaction rate is usually high and this approach contributes to patients' quality of life, stimulating the improvement of research about new concepts and techniques for NAC reconstruction.
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