D47. Nipple Sharing: Systematic Review and Meta-analysis of Techniques and Outcomes

PURPOSE: The study aimed to systematically review nipple sharing surgical techniques and outcomes. To date, no systematic reviews report nipple sharing techniques and outcomes. METHODS: MEDLINE, Embase, PubMed, and the Cochrane Database of Systematic Reviews were searched through January 30, 2023 following PRISMA guidelines for studies reporting nipple sharing techniques and outcomes. RESULTS: Among twenty eligible studies, two surgical approaches were identified: standard (n=12) and nonstandard (n=4). Standard approaches involved donor nipple partial excision, recipient site de-epithelialization, and replantation. Nonstandard approaches introduced adjunctive steps, such as mammary gland preservation. Four studies did not report surgical technique. 14 patients (5.0%, n=280) experienced complications, including nipple-areolar complex necrosis (1.4%) and graft failure (1.4%). Reconstructed nipple projection averaged 8.1 mm postoperatively and 5.28 mm 6 months postoperatively. While 76.9% found donor nipple sensation nearly normal, reconstructed nipple sensitivity worsened postoperatively. 90% of donor nipples and 42% of grafted nipples regained erectile function. Among 302 patients, 96% rated donor nipple appearance positively, 88.6% would repeat the procedure, and 96% would recommend the procedure. CONCLUSION: Nipple sharing offers superior aesthetic and patient satisfaction outcomes with low necrosis rates at recipient and donor sites. Standardizing outcome measurements can further enhance evaluation of nipple reconstruction techniques, including nipple sharing.