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Skip Navigation LinksHome > February 2011 - Volume 127 - Issue 2 > Temporary Banking of the Nipple-Areola Complex in 97 Skin-Sp...
Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e3181fed578
Breast: Original Articles

Temporary Banking of the Nipple-Areola Complex in 97 Skin-Sparing Mastectomies

Ahmed, A. Kalam J. M.D.; Hahn, Daniëla E. E. M.A., M.Sc.; Hage, J. Joris M.D., Ph.D.; Bleiker, Eveline M. A. Ph.D.; Woerdeman, Leonie A. E. M.D., Ph.D.

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Abstract

Background: Despite the improved appearance associated with skin-sparing mastectomy, removal of the nipple-areola complex has a negative impact on the patient. Still, nipple-areola complex-sparing mastectomy results in preservation of a substantial amount of mammary tissue at risk. This may be prevented by preservation of the nipple-areola complex as a graft that is temporarily banked (e.g., in the groin region).

Methods: Ninety-seven nipple-areola complexes were banked as part of preventive (n = 62) or therapeutic (n = 35) skin-sparing mastectomies in 61 women with a median age of 41 years (range, 27 to 59 years) and a minimum follow-up of 2 years. The areola was harvested as a full-thickness skin graft with the nipple attached as a composite graft. In oncologic cases, the nipple-areola complexes were banked only after frozen section clearance.

Results: Seventy-five nipple-areola complexes were replanted onto the reconstructed mammary mound after 10 months (range, 3 to 26 months). Repeated graft take was moderate to good in 73 of these 75 nipple-areola complexes. The projection of the nipple and pigmentation of the areola were moderate to good in 45 and 74 of the 75 repeatedly transplanted grafts, respectively.

Conclusions: In skin-sparing mastectomy, maximum oncologically safe conservation of autologous mammary structures can be realized by means of temporary banking of the nipple-areola complex. Even though such banking may not be successful in all women, it proved to be satisfactory in most.

©2011American Society of Plastic Surgeons

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