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Case Reports
. 2019 Nov 27;7(11):e2494.
doi: 10.1097/GOX.0000000000002494. eCollection 2019 Nov.

A Rare Case of Nipple-Areolar Complex Partial Necrosis following Micropigmentation: What to Learn?

Affiliations
Case Reports

A Rare Case of Nipple-Areolar Complex Partial Necrosis following Micropigmentation: What to Learn?

Marta Starnoni et al. Plast Reconstr Surg Glob Open. .

Abstract

A 52-year-old woman, without any comorbidity, presented at our institution for reconstruction of nipple-areolar complex (NAC). Nipple reconstruction was obtained through local skin flaps. After 2 months, a tattoo of the NAC was performed. Follow-up was planned at 6 months. Nevertheless, the patient came to our attention 2 days after tattooing for partial necrosis of the epidermal-dermal layer of the tattooed area with partial muscular layer exposition. Empirical antibiotic treatment was immediately started to avoid infection. Daily medications were performed for 3 weeks. Complete healing was obtained within 3 weeks without the necessity of a skin graft. We think that the partial necrosis of the NAC occured because of vascular impairment of the dermal and subdermal vascular plexus during micropigmentation. From this experience, we developed some advice to improve our clinical practice by allowing surgeons, especially if trainees, to avoid complications in performing NAC micropigmentation.

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Figures

Fig. 1.
Fig. 1.
Subtotal necrosis of dermis with exposition of the muscular layer after NAC micropigmentation. Residual dry scar ointment seems to be as micro-pustules.
Fig. 2.
Fig. 2.
Complete healing after 3 weeks of daily medications.

References

    1. Costa MP, Ferreira MC. Aesthetic quality of the nipple-areola complex in breast reconstruction with a new local graft technique. Aesthetic Plast Surg. 2009;33:774. - PubMed
    1. Hamori CA, LaRossa D. The top hat flap: for one stage reconstruction of a prominent nipple. Aesthetic Plast Surg. 1998;22:142–144. - PubMed
    1. Garg G, Thami GP. Micropigmentation: tattooing for medical purposes. Dermatol Surg. 2005;318 Pt 1928–931; discussion 931. - PubMed
    1. Miller LG, Perdreau-Remington F, Rieg G, et al. Necrotizing fasciitis caused by community-associated methicillin-resistant staphylococcus aureus in Los Angeles. N Engl J Med. 2005;352:1445–1453. - PubMed
    1. Long T, Coleman D, Dietsch P, et al. Methicillin-resistant Staphylococcus aureus skin infections among tattoo recipient: Ohio, Kentucky and Vermont 2004–2005. MMWR Morb Mortal Wkly Rep. 200655:677–679. - PubMed

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