الفهرس 
Embryology of the female BreastOnly 14 pages are availabe for public view
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Abstract
Patients with loss of the nipple and areola from cancer excision, trauma, or congenital absence continue to experience psychological distress even long after breast mound reconstruction has taken place. Other conditions requiring nipple areolar complex (NAC) reconstruction include congenital or developmental pathology (athelia, amastia), posttraumatic or burn deformities, and complications from breast surgery such as reduction mammaplasty. In the cases of breast cancer, whole breast reconstruction following mastectomy can provide significant psychosocial benefits for women. Nipple reconstruction can be performed with all types of breast reconstructive procedures and at any time following completion. Nipple reconstruction represents the simplest from a technical perspective but is among the most important from an aesthetic perspective.
NAC reconstruction is the final and concluding stage of breast reconstruction. Given the numerous techniques described in literature it is clear that the ideal nipple reconstruction hasn‟t been found yet. Indeed, current techniques are unable to ensure symmetry with the contralateral nipple in high and diameter and color/texture match. However, surgeons should be familiar with most nipple reconstruction techniques since one can be the best choice over another depending on type of mastectomy, radiotherapy, type of reconstruction, skin thickness, tissue condition, and patients‟ expectations.
Skate, star, cross, arrow, and C-V flap are usually surgeons‟ first choice given long-term outcomes. Common traditional flaps can be employed along or in combination of augmentation grafts. Autologous grafts ensure sustained nipple projection but donor site morbidity remains an issue as well as implant extrusion in case of alloplastic grafts. In addition, careful patient evaluation and trustful doctor-patient relationship are essential to achieve satisfying results.
In the last decade, authors tried to control and predict skin grafts pigmentation for areola reconstruction. Despite various attempts, clinical experience proves that this is difficult to achieve. A problem with all skin grafts is the morbidity of donor site, sometimes refused form patients. Therefore, in most cases, immediate areola tattooing has made skin grafting dispensable. So, tattooing is the best option for areolar reconstruction if not even the only option nowadays due to it is many advantages over skin graft. Tattooing has no donor site morbidity the used dye is permanent which guarantees color matching even if fading occurs over time simple outpatient procedure of enhancing color could be done.
The study was held in 21 female patients having nipple and areolar loss. The patients were examined and evaluated preoperatively and according to the cause of loss, previous reconstruction and patient counselling a specific surgical plan was devised. The patients were then followed up in the early postoperative period for possible complications and for at least one year after surgery to check about patient satisfaction and second look surgeries. Categorizing the patients and doing a tailored plan for each patient was the key to successful outcome. The study concluded that there is no technique is superior over the other and that there are guidelines to be followed to achieve patient satisfaction.