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Aesthetic Plastic Surgery

, Volume 42, Issue 3, pp 656–661 | Cite as

Color Change After Paramedical Pigmentation of the Nipple–Areola Complex

  • Shoichi TomitaEmail author
  • Katsuya Mori
  • Takeshi Miyawaki
Original Article Breast Surgery

Abstract

Background

Reconstruction of the nipple–areola complex is the final process in breast reconstruction. Local flaps and paramedical pigmentation is one of the major procedures for this. However, fading after paramedical pigmentation leads to a color difference between the selected pigment and its color in the skin. The aim of this study is to make a proposition in color choice of paramedical pigmentation for nipple–areola complex.

Methods

Our research focused on investigating the color changes over time after unilateral nipple–areola complex reconstruction using paramedical pigmentation in 25 patients to propose suitable color selections. We measured the color by spectrometer and conducted comparisons using the hue, saturation, and value (HSV) color space and the color space defined by the Commission International de L’eclairage based on one channel for luminance (lightness) (L) and two color channels (a and b) (L*a*b*).

Results

A comparison of the hue, value, and saturation of the reconstructed areola compared to the normal areolae was conducted using HSV color space; the value and saturation were satisfactory after 3 months and beyond, but the reconstructed areola tended to have stronger red hues. The color difference (ΔE00) calculated in L*a*b* color space showed slow fading after the scab was peeled off.

Conclusions

This result indicates that a color with less redness and more yellowness, particularly 4–5 degrees of yellowness on the color wheel, than the normal side is the most appropriate color selection for this technique.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords

Breast reconstruction Nipple–areola reconstruction Paramedical pigmentation Permanent makeup Tattoo 

Notes

Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing and Publication Support.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards and approved by the ethical committee of the Jikei University School of Medicine (8218). Informed consent was obtained from all patients.

References

  1. 1.
    Momoh AO, Colakoglu S, de Blacam C, Yueh JH, Lin SJ, Tobias AM, Lee BT (2012) The impact of nipple reconstruction on patient satisfaction in breast reconstruction. Ann Plast Surg 69:389–393CrossRefPubMedGoogle Scholar
  2. 2.
    Bykowski MR, Emelife PI, Emelife NN (2017) Nipple–areola complex reconstruction improves psychosocial and sexual well-being in women treated for breast cancer. J Plast Reconstr Aesthet Surg 70:209–214CrossRefPubMedGoogle Scholar
  3. 3.
    Millard DR (1972) Nipple and areola reconstruction by split-skin graft from the normal side. Plast Reconstr Surg 50:350–353CrossRefPubMedGoogle Scholar
  4. 4.
    Wexler MR, Oneal RM (1973) Areola sharing to reconstruct the absent nipple. Plast Reconstr Surg 51:176–178CrossRefPubMedGoogle Scholar
  5. 5.
    Adams VW (1949) Labial transplant for correction of loss of the nipple. Plast Reconstr Surg 4:295–298CrossRefGoogle Scholar
  6. 6.
    Barton FE Jr (1982) Latissimus dermal-epidermal nipple reconstruction. Plast Reconstr Surg 70:234–237CrossRefPubMedGoogle Scholar
  7. 7.
    Rose EH (1985) Nipple reconstruction with four-lobe composite auricular graft. Ann Plast Surg 15:78–81CrossRefPubMedGoogle Scholar
  8. 8.
    Klatsky SA, Manson PN (1981) Toe pulp free grafts in nipple reconstruction. Plast Reconstr Surg 68:245–248CrossRefPubMedGoogle Scholar
  9. 9.
    Kroll SS (1989) Nipple reconstruction with the double-opposing-tab flap. Plast Reconstr Surg 104:520–525CrossRefGoogle Scholar
  10. 10.
    Kroll SS, Reece GP, Miller MJ, Evans GR, Robb GL, Baldwin BJ, Wang BG, Schusterman MA (1997) Comparison of nipple projection with the modified double-opposing tab and star flaps. Plast Reconstr Surg 99:1602–1605CrossRefPubMedGoogle Scholar
  11. 11.
    Losken A, Mackay GJ, Bostwick J 3rd (2001) Nipple reconstruction using the C–V flap technique: a long-term evaluation. Plast Reconstr Surg 108:361–369CrossRefPubMedGoogle Scholar
  12. 12.
    Becker H (1986) The use of intradermal tattoo to enhance the final result of nipple areola reconstruction. Plast Reconstr Surg 77:673–675CrossRefPubMedGoogle Scholar
  13. 13.
    Spear SL, Convit R, Little JW 3rd (1989) Intradermal tattoo as an adjunct to nipple areola reconstruction. Plast Reconstr Surg 83:907–911CrossRefPubMedGoogle Scholar
  14. 14.
    Wing RK, Banducci DR, Feldman S, Kahler SH, Manders EK (1993) Pre-reconstruction tattooing eliminates the need for skin grafting in nipple areola reconstruction. Plast Reconstr Surg 92:547–549CrossRefGoogle Scholar
  15. 15.
    Hallock GG (1993) Salvage by tattooing of areolar complications following breast reduction. Plast Reconstr Surg 91:942–945CrossRefPubMedGoogle Scholar
  16. 16.
    Spear SL, Arias J (1995) Long-term experience with nipple–areola tattooing. Ann Plast Surg 35:232–236CrossRefPubMedGoogle Scholar
  17. 17.
    El-Ali K, Dalal M, Kat CC (2006) Tattooing of the nipple–areola complex: review of outcome in 40 patients. J Plast Reconstr Aesthet Surg 59:1052–1057CrossRefPubMedGoogle Scholar
  18. 18.
    Bhatty MA, Berry RB (1997) Nipple–areola reconstruction by tattooing and nipple sharing. Br J Plast Surg 50:331–334CrossRefPubMedGoogle Scholar
  19. 19.
    Levites HA, Fourman MS, Phillips BT, Fromm IM, Khan SU, Dagum AB, Bui DT (2014) Modeling fade patterns of nipple areola complex tattoos following breast reconstruction. Ann Plast Surg 73(Suppl 2):S153–S156CrossRefPubMedGoogle Scholar
  20. 20.
    Little JW, Spear SL (1988) The finishing touches in nipple–areola reconstruction. Perspect Plast Surg 2:1–22Google Scholar
  21. 21.
    Xujia Q, Yanfei CH, Yinglin F (2016) Image enhancement algorithm based on Retinex of trilateral filter in HSV color space. J Chin Comput Syst 37:168–172Google Scholar
  22. 22.
    Joblove GH, Greenberg D (1978) Color spaces for computer graphics. Comput Graph 12:20–25CrossRefGoogle Scholar
  23. 23.
    International Commission on Illumination (1978) Supplement No. 2 to CIE Publ. No. 15, Recommendations on uniform color spaces, color-difference equations, psychometric color terms. Bureau Central de la CIE, ParisGoogle Scholar
  24. 24.
    Japanese Industrial Standards (1993) JIS Z 8721:1993 Colour specification–specification according to their three attributes. Japanese Standards Association, TokyoGoogle Scholar
  25. 25.
    Goh SC, Martin NA (2011) Patient satisfaction following nipple–areolar complex reconstruction and tattooing. J Plast Reconstr Aesthet Surg 64:360–363CrossRefPubMedGoogle Scholar
  26. 26.
    Vadodaria SJ (1989) Tattooing for the management of white patches. Ann Plast Surg 23:81CrossRefPubMedGoogle Scholar
  27. 27.
    Lea PJ (1987) Human Tattoo. Electron microscopic assessment of epidermis, epidermal-dermal junction and dermis. Int J Dermatol 26:453–458CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2017

Authors and Affiliations

  • Shoichi Tomita
    • 1
    Email author
  • Katsuya Mori
    • 1
    • 2
  • Takeshi Miyawaki
    • 1
  1. 1.Department of Plastic and Reconstructive SurgeryThe Jikei University School of MedicineTokyoJapan
  2. 2.Shibuya Mori ClinicTokyoJapan

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