Patient Satisfaction Increases with Nipple Reconstruction following Autologous Breast Reconstruction

Background: Nipple reconstruction has been linked to patient satisfaction; however, there is debate about the validity of these findings in autologous breast reconstruction patients. This study hypothesized that satisfaction would increase with nipple reconstruction following autologous breast reconstruction. Methods: A comparison study was performed of autologous breast reconstruction patients. Patients completed a survey that included BREAST-Q and nipple satisfaction measures. A chart review identified reconstructive details. Results: A total of 191 patients completed the survey (48 percent response rate), with an average age of 53.7 +/- 10.0 years and follow-up time of 2.8 +/- 1.5 years. Nipple-areola complex reconstruction was completed in 33 percent of patients (63 of 191). Nipple-areola complex tattoos were used most frequently [n = 37 (58 percent)], followed by local flaps [n = 10 (16 percent)], free nipple-areola complex grafts [n = 9 (14 percent)], and a combination of local flaps and tattoos [n = 7 (11 percent)]. In comparison to women who did not undergo nipple-areola complex reconstruction, women who underwent any type of nipple reconstruction had a statistically higher BREAST-Q score for Sexual Well-Being (60 +/- 24 versus 50 +/- 22; p = 0.01), Postoperative Satisfaction with Breasts (65 +/- 11 versus 61 +/- 12; p = 0.01), and Satisfaction with Surgeon (97 +/- 6 versus 93 +/- 16; p = 0.009). The average nipple satisfaction score was 74 +/- 19. There were correlations between the nipple satisfaction score and BREAST-Q scores for Sexual Well-Being (r = 0.50; p < 0.001), Psychosocial Well-Being (r = 0.43; p < 0.001), and Postoperative Satisfaction with Breasts (r = 0.43; p < 0.001). Conclusion: Reconstruction of the nipple-areola complex is an important part of autologous breast reconstruction, resulting in increased sexual well-being and satisfaction with reconstructed breasts.