Plastic and Reconstructive Surgery, Global Open (Apr 2015)

Nipple-areolar Complex Reconstruction following Postmastectomy Breast Reconstruction: A Comparative Utility Assessment Study

  • Ahmed M. S. Ibrahim, MD,
  • Hani H. Sinno, MD, MEng,
  • Ali Izadpanah, MD, MSc,
  • Joshua Vorstenbosch, PhD,
  • Tassos Dionisopoulos, MD,
  • Marc A. M. Mureau, MD, PhD,
  • Adam M. Tobias, MD,
  • Bernard T. Lee, MD, MBA,
  • Samuel J. Lin, MD

DOI
https://doi.org/10.1097/GOX.0000000000000133
Journal volume & issue
Vol. 3, no. 4
p. e380

Abstract

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Background: Nipple-areola complex (NAC) reconstruction occurs toward the final stage of breast reconstruction; however, not all women follow through with these procedures. The goal of this study was to determine the impact of the health state burden of living with a reconstructed breast before NAC reconstruction. Methods: A sample of the population and medical students at McGill University were recruited to establish the utility scores [visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG)] of living with an NAC deformity. Utility scores for monocular and binocular blindness were determined for validation and comparison. Linear regression and Student’s t test were used for statistical analysis, and significance was set at P $10,000 revealed a statistically significant difference for VAS (P = 0.049) and SG (P = 0.015). Linear regression analysis showed that medical education was directly proportional to the SG and TTO scores (P < 0.05). Conclusions: The absence of NAC in a reconstructed breast can be objectively assessed using utility scores (VAS, 0.84 ± 0.18; TTO, 0.92 ± 0.11; SG, 0.92 ± 0.11). In comparison to prior reported conditions, the quality of life in patients choosing to undergo NAC reconstruction is similar to that of persons living with a nasal deformity or an aging neck requiring rejuvenation.