Dermatography: 10 Years of Applications as an Adjuvant Treatment after Nipple and Areola Reconstruction

Abstract

Introduction:

Nipple and areola reconstruction have recently become in demand because more women are having breast surgery because of breast cancer diagnoses. Many methods for reconstructing the nipple and areola of the breast have been described and several treatment methods have been developed to improve the aesthetic results. The purpose of this paper is to describe one method, dermatography, a refined method of medical tattooing and the results obtained from this method.

Materials and Methods:

Over 10 years, 112 patients were treated with dermatography for nipple and areola reconstructions. Of these, 89 patients had received a unilateral reconstruction and 23 received a bilateral reconstruction. The first dermatographic treatment was given 8–12 months after the last intervention by the plastic surgeon. The average session lasted 45 minutes. Results were assessed by means of a short questionnaire. Results over time were evaluated by comparing pictures from previous sessions.

Dermatography uses a modified tattooing called a dermainjector machine. Keloidectomy is the technique used to reduce keloid in postoperative scars. The needles of the dermainjector are positioned at an angle of 70–90 degrees to the scar surface. Small parts of the keloid are removed. At the same time pigmentation is performed.

Results:

Patients evaluated their results as satisfactory. Pigmentation over 5 years was judged to be stable with minor loss of pigment in only 6% of the patients, all of whom received radiation therapy for their cancer. Dermatography was well tolerated by the patients. None of the patients required local anesthesia.

Discussion:

Patients receiving total resection of their breasts are getting younger and perceiving the results as a severe deformation of their bodies. Results of reconstruction are judged very critically. We found that our patients considered the general visual aspect of the nipple and areola shape more important, and most of the patients did not consider reconstruction of the actual nipple mound to be necessary.