ABSTRACT
Nipple malformations are common congenital or acquired conditions that can have tremendous
cosmetic, psychological, breast-feeding, sexual, and hygienic ramifications. Ideal
reconstruction of the nipple-areola complex (NAC) requires symmetry in position, size,
shape, texture, pigmentation, and permanent projection, and although many technical
descriptions of NAC reconstruction exist in the medical literature, there are insufficient
data presented to accurately compare outcomes. The current article comprises a thorough
review of the literature, exploring the techniques described for NAC reconstruction,
comparing reported outcomes and complications, and providing an evidence-based approach
to NAC reconstruction. The findings of the review suggest that evidence regarding
surgical correction of nipple deformity and complete NAC reconstruction is lacking,
and loss of nipple projection over time is a pervasive problem common to all flap
techniques. A combination of a single pedicle local flap with tattooing for complete
NAC reconstruction is currently the most supported method; however, data concerning
which type of reconstruction is best suited to immediate versus delayed and type of
breast mound remain to be examined.
KEYWORDS
Nipple areola complex - breast - reconstruction - autologous - aesthetic
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Room E533, Department of Anatomy, University of Melbourne, Grattan St, Parkville,
3050 Victoria, Australia
Email: warrenrozen@hotmail.com