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The Impact of Nipple Reconstruction on Patient Satisfaction in Breast Reconstruction

Momoh, Adeyiza O. MD*; Colakoglu, Salih MD; de Blacam, Catherine MBBCh; Yueh, Janet H. MD; Lin, Samuel J. MD; Tobias, Adam M. MD; Lee, Bernard T. MD, MBA

doi: 10.1097/SAP.0b013e318246e572
Clinical Papers

Background Nipple reconstruction is an integral part of the breast reconstruction process, as patients associate this stage with closure while providing a sense of completeness. This study evaluates the effect of nipple reconstruction on patient satisfaction with breast reconstruction.

Methods All patients at Beth Israel Deaconess Medical Center undergoing breast reconstruction between 1999 and 2006 were identified. Patient demographics and complications were collected retrospectively while aesthetic and general satisfaction was evaluated by an administered survey. Patients with nipple reconstruction at the time of survey were compared to patients without nipple reconstruction.

Results Nine hundred two breast reconstructions were performed in 696 patients; 490 patients underwent nipple reconstruction and 206 did not. Autologous reconstruction predominated in patients with and without nipple reconstruction (61.8% and 54.8%, respectively). There were no significant differences in individual and overall total complications between groups. Patients with nipple reconstruction had significantly higher general (72.2% vs 52.8%, P < 0.0001) and aesthetic (70.5% vs 46.5%, P < 0.0001) satisfaction scores compared to patients without nipple reconstruction. These results were seen in unilateral and bilateral breast reconstruction. Across reconstructive techniques, patients with nipple reconstruction had higher aesthetic satisfaction. Patient satisfaction scores in all individual survey questions were statistically higher in patients with nipple reconstruction.

Conclusions Patients with breast reconstruction who undergo nipple reconstruction have higher general and aesthetic satisfaction compared to breast reconstruction alone. These differences were observed in both unilateral and bilateral reconstruction. Patients should be fully counseled about potential benefits nipple reconstruction can provide to all forms of breast reconstruction.

From the *Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, MI; and †Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Received December 6, 2011, and accepted for publication, after revision, December 15, 2011.

Presented at the 28th Annual Meeting of the Northeastern Society of Plastic Surgeons, Amelia Island, FL, October 20–23, 2011.

Conflicts of interest and sources of funding: This study was approved by the institutional review board at the Beth Israel Deaconess Medical Center, Boston, MA. This research was performed with sponsorship from the Peter Jay Sharp Foundation. Presented at the Northeastern Society of Plastic Surgeons Meeting, Amelia Island, FL, October 2011. None of the authors have a financial interest in any of the products, devices, or drugs mentioned in this article.

Reprints: Bernard T. Lee, MD, MBA, Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, 110 Francis St, Suite 5A, Boston, MA 02215. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.