Areola Reconstruction: FTSG and Micropigmentation.

Shin, Woo Jin; Hwang, Weon Jung; Ahn, Hee Chang

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2003;30(4):399-404.
Published online July 1, 2003.

Areola Reconstruction: FTSG and Micropigmentation.

Woo Jin Shin, Weon Jung Hwang, Hee Chang Ahn

Department of Plastic & Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea. ahnhc@hanyang.ac.kr

Abstract

The reconstruction of nipple and areola after breast mound reconstruction is fundamental in achieving final outcome. A variety of methods have been applied to make natural nipple and areola. The purpose of this study is to compare the operative methods and experience between FTSG and micropigmentation. Nipple-areolar complex was reconstructed after free TRAM flap for 33 breasts from May 1995 to August 2001. 20 patients underwent micropigmentation(Permark (R)) for areola and 13 patients underwent FTSG. Full thickness skin was obtained from inguinal area for FTSG method. Micropigmentation for areola was done 2 months after nipple reconstruction. There was no specific complication reported after areola reconstruction, but some differences in outcomes were noted between the two methods of areola reconstruction. First of all, there was an advantage in time saving for FTSG method due to simultaneous reconstruction of nipple and areola. However, FTSG has several disadvantages such as longer operation time, sometimes prominent scar formation of the inguinal and circumareolar region, feeling of shame due to location of the donor site, the lightening of the areolar color with time, and finally the color difference between the nipple and areola. Micropigmentation has advantages with simple procedure, short operation time, no donor site scar, no shameful feelings for dressing, no color change of areola with time, and easier color selection for the areola and nipple. It has disadvantages of double operation due to separate nipple and areola reconstruction, need for additional instruments, and experience in selection of well matched paste. FTSG from the inguinal region often had been used to produce the similar color of areola and was thought to be the standard method. However, we thought that areolar reconstruction utilizing micropigmentation is much better than FTSG in terms of cosmesis and convenience for operation.

Keywords: Areola reconstruction; Micropigmentation

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