Document Detail


Nipple Reconstruction: Risk Factors and Complications after 189 Procedures.
MedLine Citation:
PMID:  24072956     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: A multitude of different approaches have been proposed for achieving optimal aesthetic results after nipple reconstruction. In contrast, however, only a few studies focus on the morbidity associated with this procedure, particularly after implant-based breast reconstruction.
METHODS: Using a cross-sectional study design all patients who underwent implant-based breast reconstruction with subsequent nipple reconstruction between 2000 and 2010 at Stanford University Medical Center were identified. The aim of the study was to analyze the impact of the following parameters on the occurrence of postoperative complications: age, final implant volume, time interval from placement of final implant to nipple reconstruction, and history of radiotherapy.
RESULTS: A total of 139 patients with a mean age of 47.5 years (range, 29 to 75 years) underwent 189 nipple reconstructions. The overall complication rate was 13.2 percent (N = 25 nipple reconstructions). No association was observed between age (p = 0.43) or implant volume (p = 0.47) and the occurrence of complications. A trend towards higher complication rates in patients in whom the time interval between final implant placement and nipple reconstruction was greater than 8.5 months was seen (p = 0.07). Radiotherapy was the only parameter that was associated with a statistically significant increase in postoperative complication rate (51.7 percent vs. 6.25 percent; p < 0.00001).
CONCLUSION: While nipple reconstruction is a safe procedure after implant-based breast reconstruction in patients without a history of radiotherapy, the presence of an irradiated field converts it to a high-risk one with a significant increase in postoperative complication rate. Patients with a history of radiotherapy should be informed about their risk profile and as a result may choose autologous reconstruction instead.
LEVEL OF EVIDENCE: IV.
Authors:
Arash Momeni; Mina Ghaly; Deepak Gupta; Yvonne L Karanas; David M Kahn; Geoffrey C Gurtner; Gordon K Lee
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  European journal of plastic surgery     Volume:  36     ISSN:  0930-343X     ISO Abbreviation:  Eur J Plast Surg     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-9-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8700891     Medline TA:  Eur J Plast Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  633-638     Citation Subset:  -    
Affiliation:
Division of Plastic and Reconstructive Surgery, Stanford University Medical Center.
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