Background:
Due to the increasement in breast reconstruction within recent years, nipple-areola complex reconstruction assumes a tremendous psychological significance for patients, who commonly regard its completion as the final leg of the reconstructive journey. Furthermore, nipple-areola complex reconstruction has been associated with higher levels of general and aesthetic satisfaction compared with breast reconstruction alone.

Patients and methods:
A retrospective review of nipple-areola complex reconstruction managed by a single senior plastic and reconstructive surgeon at Kaohsiung Chang Gung Memorial Hospital with local flaps over a 10-year period (2012 to 2022) was conducted. Of these, 15 nipple-areola complex reconstructive procedures were performed as secondary revision after breast reconstruction.
The nipple-areola complex reconstruction type we used was nipple sharing method, which inset the composite tissue harvested from the contralateral healthy papule in a spiral configuration followed by a full-thickness skin graft from the labia majora. We collected age, type of breast reconstruction and the complications as parameters, then measured color, symmetry, projection status, and the final outcome satisfaction with 5-point Likert Scale, giving from both patients and the doctor.

Results:
In this series, we performed nipple-areola complex reconstruction for 15 patients after single side breast reconstruction. All of the procedures achieved good aesthetic results, except for 9 of the cases encountered minimal or partial superficial skin graft lost. According to the final outcome satisfaction measured by 5-point Likert scale, all of the patients were quite satisfied with the results after the surgery.

Conclusion
Nipple-areola complex reconstruction using nipple sharing method is considered a safe and convenient method with a favorable outcome for long-term maintenance of nipple appearance.