The Impact of Nipple Reconstruction on Patient Satisfaction in Breast Reconstruction

Background: Nipple reconstruction is an integral part of the breast reconstruction process, as patients associate this stage with closure while providing a sense of completeness. This study evaluates the effect of nipple reconstruction on patient satisfaction with breast reconstruction. Methods: All patients at Beth Israel Deaconess Medical Center undergoing breast reconstruction between 1999 and 2006 were identified. Patient demographics and complications were collected retrospectively while aesthetic and general satisfaction was evaluated by an administered survey. Patients with nipple reconstruction at the time of survey were compared to patients without nipple reconstruction. Results: Nine hundred two breast reconstructions were performed in 696 patients; 490 patients underwent nipple reconstruction and 206 did not. Autologous reconstruction predominated in patients with and without nipple reconstruction (61.8% and 54.8%, respectively). There were no significant differences in individual and overall total complications between groups. Patients with nipple reconstruction had significantly higher general (72.2% vs 52.8%, P < 0.0001) and aesthetic (70.5% vs 46.5%, P < 0.0001) satisfaction scores compared to patients without nipple reconstruction. These results were seen in unilateral and bilateral breast reconstruction. Across reconstructive techniques, patients with nipple reconstruction had higher aesthetic satisfaction. Patient satisfaction scores in all individual survey questions were statistically higher in patients with nipple reconstruction. Conclusions: Patients with breast reconstruction who undergo nipple reconstruction have higher general and aesthetic satisfaction compared to breast reconstruction alone. These differences were observed in both unilateral and bilateral reconstruction. Patients should be fully counseled about potential benefits nipple reconstruction can provide to all forms of breast reconstruction.