Nipple-areola complex reconstruction after postmastectomy breast reconstruction in Taiwanese females

Background: Breast reconstruction plays an important role to regain a semblance of lost breast due to mastectomy, rebuild body image, restore femininity, and to provide psychosocial benefits. Nipple-areola reconstruction is an integral part of breast reconstruction and has important symbolic and aesthetic implications. This study evaluated the results and patient's satisfaction of nipple-areola reconstruction using a badge flap and intradermal tattoo in Taiwanese females. Methods: This was a prospective study based on 3-year experience of 16 nipple-areola reconstructions in 15 patients with autologous breast reconstruction. The diameter of the new nipple was equal to the opposite native nipple or in accordance with the patient's wishes, the badge flap was trapezoid in shape and its length was calculated mathematically (L=2πr) while its width formed the height of the future nipple. Tattooing after the new nipple properly healed completed the areola. Results: All flaps survived well with good contour and symmetry. There was no partial necrosis or other complications. The new nipple kept 67.3% projection within 25.7 months follow-up (range 12-39 months). The pigmentation was determined by patients' questionnaire with a rating 8.4/10. The overall satisfaction rate was 91.5%. Conclusions: This novel badge flap with intradermal tattoo is a simple and reliable flap for nipple areola reconstruction; it gives patient good psychological support and a very good aesthetic result with inconspicuous donor scar.