A systematic review of risks and benefits with nipple-areola-reconstruction

Research output: Contribution to journalReview article


Background: Most women who have their breast reconstructed are offered NAC reconstruction. Nonetheless, it is unclear what scientific evidence there is for the procedure. The aims of the present systematic review were to evaluate the quality of evidence for benefits and risks with NAC reconstruction, and to examine the evidence for different techniques. Methods: Relevant databases were searched. Inclusion criteria were controlled studies comprising ≥20 patients and a case series of ≥50 patients. Included articles had to meet criteria defined in a PICO (Patient, Intervention, Comparison, and Outcome). Data extraction and collection were performed according to the QUADAS tool. The level of evidence of the selected articles was assessed according to the Oxford Centre for Evidence-Based Medicine 2009 guidelines, and total evidence for the different research questions was graded according to the GRADE-system. Results: A total of 362 abstracts were retrieved following the search. Of these 325 did not meet the inclusion criteria and were excluded, leaving 37 studies to be included in the review. Among these, 36 were case series and one a small randomised non-blinded study Conclusions: The existing quality of evidence for risks and benefits of the operation is very low. It is unclear what the complication frequencies are after the reconstruction, and what effect on quality-of-life the operation has. Prospective studies of high quality are needed to evaluate the health effects and risks with NAC reconstruction.


External organisations
  • Haukeland University Hospital
  • Sahlgrenska University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Surgery


  • areola, complications, evidence based medicine, NAC, nipple, prom, reconstruction
Original languageEnglish
Pages (from-to)287-295
JournalJournal of Plastic Surgery and Hand Surgery
Issue number5
Early online date2016 Nov 24
Publication statusPublished - 2017
Publication categoryResearch