Article Abstract

Nipple sharing: an undervalued technique in nipple reconstruction

Authors: Thessa Rebecca Friebel, Sonya Gardiner, Shetha Naji, Bhagwat S. Mathur


Background: Nipple reconstruction is an important stage within the patient’s breast reconstructive journey. It can be performed surgically by using local flap or nipple share techniques. Despite evidence in the literature favoring the results after nipple share procedures and associated high patient satisfaction, this technique is infrequently offered to patients in our unit, where over 300 autologous breast reconstructions are performed yearly.
Methods: A survey was conducted evaluating the preferred nipple reconstruction technique of the eight plastic surgeons performing breast reconstruction in our unit. In addition, 60 patients who had had a nipple reconstruction procedure were given questionnaires to assess their satisfaction with aspects of their nipple reconstruction.
Results: Only one of the eight plastic surgeons preferred nipple sharing over a local flap reconstruction. The experience with nipple sharing was very limited in this group of highly experienced breast reconstructive surgeons. Reasons for not performing nipple sharing were diverse and not in line with the current literature or results of our patient questionnaire. The response rate of the patient questionnaires was 53%. Patients of the nipple share group where more satisfied with each aspect of their nipple reconstruction and no donor nipple morbidity was reported in this group. One hundred percent patients in the nipple share group said that they would have the same procedure again compared to a lower 80% in the local flap group.
Conclusions: Our nipple share patient group were more satisfied with all aspects of the nipple reconstruction compared to the local flap group. We propose that unfamiliarity with the nipple share technique and misconceptions regarding its results are the main reasons for it not being offered. In our experience, nipple sharing can result in superior aesthetic outcomes and high patient satisfaction, especially in women with larger nipples who benefit from a contralateral nipple reduction.