Hyaluronic Acid Gel Filler for Nipple Enhancement Following Breast Reconstruction
The loss of the 3-dimensional contour of the nipple-areola complex (NAC) following surgical breast reconstruction is a technical challenge for the physician and a psychological burden for many breast cancer patients. The use of injectable dermal fillers to enhance nipple projection is a simple noninvasive procedure with immediate and adjustable volume results that positively impact patient satisfaction. The utility and safety of injectable hyaluronic acid (HA) gel make it an ideal filler for restoring the natural feel and contour to the delicate structure of the NAC and in some cases may represent a simple solution following breast reconstruction.
Practice Points
- The use of injectable hyaluronic acid (HA) gel to restore 3-dimensional contour of the nipple following nipple-areola complex (NAC) reconstruction is a noninvasive procedure that contributes to patient well-being.
- The use of HA gel for NAC augmentation can be performed in an office setting and may eliminate the need for secondary reconstructive surgeries.
Comment
With a single treatment consisting of 0.2 mL or less of filler volume, the HA gel used in this procedure provided an immediate mean increase in nipple projection of 1.5 mm. Although our assessment involved a single patient evaluated at baseline and immediately post-injection of HA filler only, it is reasonable to assume that subsequent reinjections would provide results comparable to other fillers. Although other fillers that are semipermanent (acrylic hydrogel) and nonbiodegradable (PMMA) make them more durable, these properties also make the augmentation less reversible in the case of overfilling. As with all dermal fillers, rare side effects associated with injection of HA gel filler could potentially include injection-site inflammation, extrusion of filler at the needle insertion site, minimal pain or discomfort during or after injections, bruising, swelling, or delayed-type hypersensitivity reaction. Ideally, HA gel is a soft transparent filler that is reversible with hyaluronidase, an advantage not shared by other filler materials.9
Conclusion
Nipple augmentation with HA gel is a simple noninvasive
