Nipple Reconstruction Using the "Arrow Flap" Technique: Outcomes and Patients Satisfaction

Clin Breast Cancer. 2024 Jun;24(4):e226-e231. doi: 10.1016/j.clbc.2024.01.011. Epub 2024 Jan 24.

Abstract

Introduction: Skin-sparing mastectomy (SSM) entails complete removal of the breast tissue and the nipple and areola complex (NAC) with preservation of as much of the overlying skin as possible. The preservation of the natural skin envelope during SSM improves the aesthetic outcome of immediate breast reconstruction, but the lack of NAC determines that the reconstructed breast remains anatomically incomplete with not always satisfactory final results. For this purpose, the aim of the present study was to investigate and evaluate the impact of nipple reconstruction after skin sparing and skin reducing mastectomy on the patients' perception and intimate life.

Materials and method: This was a comparative single-center prospective study that involved 42 patients underwent NAC reconstruction after SSM. A pre- and postoperative quality-of-life and psychological questionnaires Breast-Q questionnaire (Breast Conserving therapy module) were given to all the patients before the surgery and 6 months after. The statistical analysis with chi-square test was performed.

Results: After 6 months a prevalence of patients reported to be very satisfied in regard to shape, appearance, naturalness, projection, position and symmetry. The study shows an overall improvement in all the psychological items analyzed with statistically significant difference regarding: "patient's satisfaction," "self-confidence," "appearance of the breast."

Conclusion: The authors believe that the NAC reconstruction has useful functional and aesthetic results particularly appreciated by patients who feel demoralized after breast demolition surgery.

Keywords: Breast-Q questionnaire; Cac; Local flap; Mastectomy; Patients reported outcome.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms* / psychology
  • Breast Neoplasms* / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Mammaplasty* / methods
  • Mammaplasty* / psychology
  • Mastectomy / psychology
  • Middle Aged
  • Nipples* / surgery
  • Patient Satisfaction*
  • Prospective Studies
  • Quality of Life*
  • Surgical Flaps*
  • Surveys and Questionnaires
  • Treatment Outcome