Reconstrucción del complejo areola-pezón: Revisión de 60 casos

Abstract

The creation of the nipple-areola complex is the latest time in breast reconstruction, transforming the reconstruction of the breast mound into a real breast. We have to consider the reconstruction of the areola and the nipple as the culmination of breast reconstruction. There are a lot of documented techniques for nipple-areola complex reconstruction. The aim of this study is to determine the grade of psychological satisfaction of patients after this reconstruction This study was designed as a retrospective clinic review of 60 patients. After reviewing medical histories, the patients were interviewed and asked to complete a questionnaire. The most common desired aspect was to correct the absence/lost of nipple projection. However, 22% of patients answered they would not change anything regarding their reconstruction. The satisfaction with the mammary mound was excellent or good for 68%, normal for 23 % and poor for 9 %. On the other hand, satisfaction for the nipple-areola complex reconstruction was excellent or good for 50%, normal for 45% and poor for 5%. There were no statistical differences among the different techniques depending on the time between the mastectomy intervention and the third reconstruction (p=0,06). For nipple reconstruction, the contralateral nipple donation technique offered more satisfaction (2.67 points) and projection (7.23 points). In spite of the differences in their means, there were no statistically significant differences. Taking into account the technique used for the areola reconstruction, the donation-graft of inguinal skin was the one that offered more satisfaction (3 points) and better coloration (8.57 points). With the statistical study there were obtained significant statistical differences (p=0,01). Among the different techniques for nipple reconstruction there wasn't anyone whose results overlapped the others, but when the areola was reconstructed there were some, being the inguinal grafting the technique which satisfies more. In spite of this, the aspect which most needed to improve is nipple reconstruction because many patients were unhuppy with the obtained projection and its reabsorption over time.