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Donor-Site Morbidity and Patient Satisfaction Using a Composite Nipple Graft for Unilateral Nipple Reconstruction in the Radiated and Nonradiated Breast

Spear, Scott L. M.D.; Schaffner, Adam D. M.D.; Jespersen, M. Renée M.D.; Goldstein, Jesse A. M.D.

Plastic and Reconstructive Surgery: April 2011 - Volume 127 - Issue 4 - p 1437-1446
doi: 10.1097/PRS.0b013e318208d107
Breast: Original Articles

Background: The number of techniques available for nipple reconstruction underscores the notion that achieving an acceptable result remains a challenge. To better assess the value of a composite nipple graft in unilateral breast reconstruction, a study was performed to evaluate donor-site morbidity and patient satisfaction using a composite nipple graft for unilateral nipple reconstruction following mastectomy and reconstruction in radiated and nonradiated patients.

Methods: A retrospective chart review of all patients who underwent composite nipple reconstruction between October of 1993 and February of 2010 was performed. Medical records were reviewed for outcomes and complications. Each patient was asked to complete a previously validated survey to rate color and projection of both nipples, sensation, and contractility of the donor nipple, and whether she would, in retrospect, have the procedure again.

Results: Fifty-nine patients were identified who underwent nipple reconstruction using a composite nipple graft. Thirty-four patients (57.6 percent) responded to the survey. Four surveys were returned due to an invalid address. Average time to breast mound completion was 6 months. Average time to complete nipple reconstruction was 3.6 months after breast mound completion. Ninety-seven percent of the reconstructions were successful.

Conclusions: Composite nipple reconstruction is a useful technique that should be considered in unilateral nipple reconstruction and should be especially considered in patients whose breast has been irradiated, for which flap reconstruction for the nipple can be riskier. Although it is not possible to use in all patients, no other technique provides a nipple reconstruction that can so closely match the contralateral side in color, texture, and overall appearance.

Washington, D.C.

From the Department of Plastic and Reconstructive Surgery, Georgetown University Hospital.

Received for publication July 26, 2010; accepted September 20, 2010.

Presented at Plastic Surgery 2010, the Annual Meeting of the American Society of Plastic Surgeons, in Toronto, Ontario, Canada, October 3, 2010.

Disclosure:None of the authors has any financial interests or disclosures related to this article.

Scott L. Spear, M.D., Department of Plastic and Reconstructive Surgery, Georgetown University Hospital, 3800 Reservoir Road, N.W., First Floor PHC, Washington, D.C. 20007-2113,

©2011American Society of Plastic Surgeons