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Nipple-Areola Complex Reconstruction

Gougoutas, Alexander J. M.D.; Said, Hakim K. M.D.; Um, Grace M.D.; Chapin, Anne P.A.-C.; Mathes, David W. M.D.

Plastic and Reconstructive Surgery: March 2018 - Volume 141 - Issue 3 - p 404e-416e
doi: 10.1097/PRS.0000000000004166
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Learning Objectives: After studying this article, the participant should be able to: 1. Understand how to determine nipple-areola complex positioning on the reconstructed breast. 2. Understand the multitude of local flap and distant graft options for nipple-areola complex reconstruction. 3. Draw at least three fundamental nipple-areola complex reconstruction patterns. 4. Understand the forces that are responsible for flattening of the reconstructed papule. 5. Understand the current techniques used in secondary nipple-areola complex reconstructions.

Summary: Nipple-areola complex reconstruction and tattooing represent the final two stages of breast reconstruction. Nipple-areola complex reconstruction is typically accomplished with the use of local flaps, local flaps with augmentation grafts, or a combination thereof. Regardless of the technique used, however, all nipple-areola complex reconstructions lose a degree of projection over time. Options for secondary reconstruction include the use of local tissue flaps alone or in combination with acellular biological matrices.

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Seattle, Wash.; and Denver, Colo.

From the Center for Reconstructive Surgery, University of Washington Medical Center; and the University of Colorado Hospital, University of Colorado.

Received for publication April 30, 2017; accepted October 23, 2017.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Related Video content is available for this article. The videos can be found under the “Related Videos” section of the full-text article, or, for Ovid users, using the URL citations published in the article.

Alexander J. Gougoutas, M.D., 1959 NE Pacific Street, Box 356410, Seattle, Wash. 98195,

Copyright © 2018 by the American Society of Plastic Surgeons