Tattooing to reconstruct Nipple-Areola Complex after oncological breast surgery: a scoping review.

PURPOSE: The dermopigmentation of the Nipple-Areola Complex (NAC) is a safe non-surgical reconstruction technique that can restore psychophysical integrity, representing the final step after oncological surgery. This scoping review aims to identify and synthesize the literature focused on medical tattooing for NAC reconstruction in women who underwent breast reconstruction after cancer surgery. Competence and training, outcomes and organizational aspects were assessed as specific outcomes. METHODS: The Joanna Briggs Institute (JBI) methodology for scoping reviews was followed. MEDLINE, Embase, Cochrane Library, Clinical Key, Scopus and Cinahl databases were consulted. After title (N = 54) and abstract (N = 39) screening and full-text review (N = 18), articles that met eligibility criteria were analyzed, critically apprised and narratively synthesized. RESULTS: 13 articles were analysed, with full texts (N = 11) and only abstract (N = 2). The overall quality of the literature (N observational studies = 11; N pilot experimental studies = 2) is weak. Nurses were the professionals mostly involved (N = 6), then medical staff (N = 4) and tattoo artists (N = 2). The professional training is poorly described in 6 papers. The most frequently assessed outcome was the satisfaction rate (N = 8). One study explored aspects of quality of life with a validated questionnaire. The management of these services resulted variable. Nurse-led services were implemented in 2 studies. CONCLUSION: Despite methodological weaknesses, NAC tattooing research is relevant because it helps women redefine their identity after demolitive cancer treatments. Further research on processes and outcomes is needed.

Methods for Tattooing Xenopus laevis with a Rotary Tattoo Machine.

Animal models expand the scope of biomedical research, furthering our understanding of developmental, molecular, and cellular biology and enabling researchers to model human disease. Recording and tracking individual animals allows researchers to reduce the number of animals required for study and refine practices to improve animal wellbeing. Several well-documented methods exist for marking and tracking mammals, including ear punching and ear tags. However, methods for marking aquatic amphibian species are limited, with the existing resources being outdated, ineffective, or prohibitively costly. In this manuscript, we outline methods and best practices for marking Xenopus laevis with a rotary tattoo machine. Proper tattooing results in high-quality tattoos, making individuals easily distinguishable for researchers and posing minimal risk to animals' health. We also highlight the causes of poor-quality tattoos, which can result in tattoos that fade quickly and cause unnecessary harm to animals. This approach allows researchers and veterinarians to mark amphibians, enabling them to track biological replicates and transgenic lines and to keep accurate records of animal health.

Surgical Tattoos in Infrared: A Dataset for Quantifying Tissue Tracking and Mapping.

Quantifying performance of methods for tracking and mapping tissue in endoscopic environments is essential for enabling image guidance and automation of medical interventions and surgery. Datasets developed so far either use rigid environments, visible markers, or require annotators to label salient points in videos after collection. These are respectively: not general, visible to algorithms, or costly and error-prone. We introduce a novel labeling methodology along with a dataset that uses said methodology, Surgical Tattoos in Infrared (STIR). STIR has labels that are persistent but invisible to visible spectrum algorithms. This is done by labelling tissue points with IR-fluorescent dye, indocyanine green (ICG), and then collecting visible light video clips. STIR comprises hundreds of stereo video clips in both in vivo and ex vivo scenes with start and end points labelled in the IR spectrum. With over 3,000 labelled points, STIR will help to quantify and enable better analysis of tracking and mapping methods. After introducing STIR, we analyze multiple different frame-based tracking methods on STIR using both 3D and 2D endpoint error and accuracy metrics. STIR is available at https://dx.doi.org/10.21227/w8g4-g548.

Engineered Bacteria as Living Biosensors in Dermal Tattoos.

Dermal tattoo biosensors are promising platforms for real-time monitoring of biomarkers, with skin used as a diagnostic interface. Traditional tattoo sensors have utilized small molecules as biosensing elements. However, the rise of synthetic biology has enabled the potential employment of engineered bacteria as living analytical tools. Exploiting engineered bacterial sensors will allow for potentially more sensitive detection across a broad biomarker range, with advanced processing and sense/response functionalities using genetic circuits. Here, the interfacing of bacterial biosensors as living analytics in tattoos is shown. Engineered bacteria are encapsulated into micron-scale hydrogel beads prepared through scalable microfluidics. These biosensors can sense both biochemical cues (model biomarkers) and biophysical cues (temperature changes, using RNA thermometers), with fluorescent readouts. By tattooing beads into skin models and confirming sensor activity post-tattooing, our study establishes a foundation for integrating bacteria as living biosensing entities in tattoos.

Despigmentação precoce em caso de ceratopigmentação / Early depigmentation in case of keratopigmentation

RESUMO A ceratopigmentação teve seu primeiro registro pelo filósofo Galeno há muitos séculos como uma estratégia utilizada para o tratamento estético de pacientes com leucomas. As córneas com leucoma são patológicas e, muitas vezes, intolerantes a lentes de contato cosméticas ou próteses oculares, sendo comum a queixa de desconforto excessivo, proporcionado pela superfície corneana irregular. Assim, a ceratopigmentação é uma alternativa para a melhora estética de pacientes com opacidades corneanas. Descrevemos o caso de um paciente do sexo masculino, 39 anos, que apresentou despigmentação precoce em caso de ceratopigmentação associado a quadro de ceratite herpética necrotizante. O paciente foi submetido ao tratamento com aciclovir 2g ao dia e doxiciclina 200mg ao dia, evoluindo com melhora do quadro clínico, apesar da má adesão medicamentosa.

ABSTRACT Keratopigmentation was first recorded many centuries ago by the philosopher Galeno, as a strategy used for the aesthetic treatment of patients with leukomas. Corneas with leucoma are pathological and often intolerant of cosmetic contact lenses or ocular prostheses, with complaints of excessive discomfort provided by the irregular corneal surface being common. Therefore, keratopigmentation is an alternative for the aesthetic improvement of patients with corneal opacities. We describe the case of a 39-year old male patient, who presented early depigmentation in a case of keratopigmentation associated with necrotizing herpetic keratitis. The patient was treated with Acyclovir 2g/day and Doxycycline 200mg/day, evolving with clinical improvement, despite poor medication adherence.

Ceratopigmentação (tatuagem corneana): utilização de técnicas combinadas para melhora estética em olhos de pacientes com opacidades corneanas / Keratopigmentation (corneal tattooing): use of combined techniques for aesthetic improvement in eyes of patients with corneal opacities

RESUMO Objetivo: Relatar, por meio de uma série de casos, a percepção de pacientes com opacidade corneana sobre a eficácia da tatuagem na melhoria estética de seus olhos, utilizando a combinação de duas técnicas. Métodos: Oito pacientes responderam a um inquérito sobre sua satisfação estética com o procedimento, o desconforto pós-operatório e o impacto social observado após a cirurgia. Resultados: Todos os pacientes consideraram-se muito satisfeitos com os resultados. Em relação ao grau de desconforto no pós-operatório, 75% disseram ter tido pouco desconforto, e 25% relataram desconforto moderado. Todos os pacientes relataram melhora significativa no bem-estar social e pessoal. Da mesma forma, todos os pacientes disseram que repetiriam o procedimento. Conclusão: A tatuagem corneana surge como um método alternativo às lentes de contato e às próteses oculares em pacientes cegos com leucomas, trazendo resultados estéticos satisfatórios, duradouros e que podem promover impactos sociais na vida desses pacientes.

ABSTRACT Objective: To report, through a case series, the perception of patients about the effectiveness of corneal tattooing in the cosmetic improvement of their eyes with leukomas, using a combination of two techniques. Methods: Eight patients answered a survey regarding their cosmetic appearance satisfaction regarding the procedure, postoperative discomfort, and social impact observed after surgery. Results: All patients considered themselves very satisfied with the cosmetic results. Regarding the degree of postoperative discomfort, 75% said they had little discomfort, while 25% reported moderate discomfort. All patients reported significant improvement in social and personal well-being. Likewise, all patients said they would repeat the procedure. Conclusion: Corneal tattooing appears as an alternative method to contact lenses and ocular prostheses in impaired eyes with leukomas, bringing satisfactory and long-lasting cosmetic improvement that can promote social impacts for these patients.

Tatuagem associada ao retalho em C-V para reconstrução do complexo areolopapilar em tempo único / Tattooing associated with C-V flap placement in one-stage reconstruction of the nipple-areola complex

Introdução: A reconstrução do complexo areolopapilar (CAP) é etapa fundamental no tratamento do câncer de mama. Tipicamente, é realizada em dois tempos distintos, sendo primeiro a papila reconstruída e somente após sua completa cicatrização que a tatuagem é realizada. Métodos: Estudo retrospectivo realizado no período de 2015 a 2016 no Hospital São Lucas da PUCRS. Foram incluídas 21 pacientes com ausência do CAP unilateral. É descrita a técnica de reconstrução da papila com retalho local em C-V associado à tatuagem para pigmentação do CAP em tempo único. Foram apresentados os dados referentes ao tipo de reconstrução mamária realizada, às complicações e à presença de radioterapia prévia. Resultados: A maioria das pacientes foi reconstruída com implante (48%). Houve três complicações relacionadas à papila (14%), uma necrose parcial e duas deiscências pequenas. Não houve complicação relacionada à tatuagem. Onze pacientes (52%) haviam realizado radioterapia prévia na mama. Conclusão: A tatuagem associada ao retalho em C-V em tempo único é uma técnica simples e com baixo índice de complicações.

Introduction: Reconstruction of the nipple-areola complex (NAC) is a fundamental step in the treatment of breast cancer. It is usually performed in two distinct stages. Tattooing is performed only after reconstruction and complete scarring of the nipple. Methods: This retrospective study was conducted from 2015 to 2016 at the Hospital São Lucas of the Pontifical Catholic University of Rio Grande do Sul. Twenty-one patients with a single NAC were included. One-stage reconstruction of the nipple using a local C-V flap associated with tattooing for pigmentation of the NAC is described. Data on the type of breast reconstruction performed, associated complications, and presence of previous breast radiotherapy were presented. Results: Most patients (48%) underwent reconstruction with an implant. Three complications (14%) were observed in the nipple, including one case of partial necrosis and two cases of small dehiscence. None of the patients had complications due to tattooing. Eleven patients (52%) underwent breast radiotherapy previously. Conclusion: Tattooing combined with one-stage reconstruction using a C-V flap is a simple technique with a low rate of complication.

Reconstrução da papila e imediata tatuagem do complexo areolopapilar: técnica, resultados e revisão de literatura / Reconstruction of the papilla and immediate tattooing of the nipple-areola complex: the technique, results, and a literature review

Introdução: A reconstrução do complexo areolopapilar (RecCAP) constitui-se na etapa final da reconstrução mamária, estando a tatuagem do complexo areolopapilar (CAP) bem estabelecida como efetiva, apesar de pouco difundida entre cirurgiões plásticos brasileiros. Nós mostramos um método simples de RecCAP com a utilização de retalhos cutâneos para confecção da papila e imediata tatuagem do CAP encurtando a recuperação do paciente e evitando novos tempos cirúrgicos. Métodos: Foi realizado um estudo retrospectivo de pacientes submetidas à RecCAP em nossa clínica privada, no período de setembro de 2015 a dezembro de 2016. Também se procedeu uma pesquisa na base de dados Medline no período de 2004 a 2016, incluindo relatos de doenças associadas à tatuagem. Resultados: Vinte e seis pacientes foram submetidos a 28 reconstruções do complexo areolopapilar, com faixa etária média de 48 anos (variando de 29 a 65 anos), não havendo maiores complicações, com exceção da irregularidade na absorção do pigmento em oito reconstruções (28,5%). Conclusão: A utilização de técnicas de tatuagem na confecção do complexo areolopapilar mostrou-se eficaz, com mínima morbidade e de fácil execução, com altos índices de satisfação do paciente, apesar da necessidade de retoques futuros na obtenção da tonalidade ideal.

Introduction: The reconstruction of the nipple-areola complex (NACRec) is the final stage of breast reconstruction; and tattooing the nipple-areola complex (NAC) is well established as effective, although not widespread among Brazilian plastic surgeons. We have shown a simple method of NACRec using skin flaps for the preparation of the papilla and immediate tattooing of the NAC, shortening the recovery of the patient and avoiding new surgeries. Methods: We performed a retrospective study of patients submitted to NACRec in our private clinic, from September 2015 to December 2016. We also searched the Medline database from 2004 to 2016 for reports of diseases associated with tattooing. Results: Twenty-six patients underwent 28 reconstructions of the nipple-areola complex, with a mean age of 48 years (ranging from 29 to 65 years), with no major complications, except for the irregularity in pigment absorption in eight reconstructions (28.5%). Conclusion: The use of tattooing techniques in the preparation of the nipple-areola complex proved to be effective, with minimal morbidity, and easy to perform, with high patient satisfaction rates, despite the need for a future touch-up to obtain the ideal shade.

Conjunctival tattoo: report on an emerging body modification trend / Tatuagem conjuntival: relato de uma crescente tendência de modificação do corpo

ABSTRACT We report the case of a patient who received conjunctival tattooing for cosmetic purposes with associated complications. A 28-year-old male experienced severe ocular pain after undergoing conjunctival tattooing. Slit-lamp examination revealed blue deposits over the conjunctiva in association with intense conjunctival edema and a 4+ anterior chamber cellular reaction. The patient underwent clinical treatments to control ocular inflammation. Two months after the injury, the patient was still in follow-up to ensure that any further complications were managed and documented. This unusual case of conjunctival tattooing resulted in conjunctival edema and anterior uveitis. Because of the increasing popularity of eyeball tattooing, the potentially severe complications of this procedure may become more common.

RESUMO Relatamos um caso de um paciente que realizou tatuagem conjuntival para fins cosméticos com complicações associadas. Um homem de 28 anos de idade apresentou dor ocular importante após tatuagem conjuntival. O exame da lâmpada de fenda revelou depósitos azuis sobre a conjuntiva, associados a um intenso edema conjuntival e uma reação de câmara anterior de 4+ de células. O paciente foi submetido a tratamentos clínicos para controlar a inflamação ocular. Dois meses após o ocorrido, o paciente ainda estava em acompanhamento para garantir que quaisquer outras complicações fossem gerenciadas e documentadas. Um caso incomum de tatuagem conjuntival resultou em edema conjuntival e uveíte anterior. Devido à crescente popularidade da tatuagem no globo ocular, complicações potencialmente graves deste procedimento podem se tornar mais comuns.

Remoção de tatuagem com laser Q-switched NdYAG em população brasileira / Tattoo removal with Q-switched Nd: YAG laser in a Brazilian population

INTRODUÇÃO: Na prática da remoção de tatuagem, já foram utilizadas a dermo a brasão e a cirurgia. Atualmente, se utiliza o laser. O objetivo deste trabalho foi avaliar a remoção de tatuagens utilizando-se o laser Q-switched NdYAG. MÉTODO: Estudo retrospectivo, com pacientes tratados com laser Q-switched NdYAG. Foram coletados dados a partir de prontuários e fotos dos pacientes, e de contato por telefone ou e-mail. A análise estatística foi feita através da análise de distribuição, regressão multivariada e regressão logística. RESULTADOS: Foram avaliados 304 pacientes com média de idade de 29,8 anos (±7,86), sendo que 297 (97,69%) foram classificados como brancos (fotótipos I, II e III); destes, 270 (88,81%) haviam feito tatuagens profissionais. A tatuagem mais antiga tinha 360 meses e a mais recente, um mês, obtendo-se uma média de 64,56 meses (± 63,54). O tamanho das tatuagens foi, em média, de 12,92 cm, sendo preta a cor predominante, estando presente em 291(86,51%) tatuagens. A média de sessões por paciente foi de 3,77 sessões (±2,99) e o intervalo entre estas foi de 49,23 dias. Com isso, foi observado, pelo terapeuta, que 52,96% das tatuagens foram parcialmente removidas; 21,38%, não removidas; 86,51%, cicatrização normal; 8,55%, cicatriz hipertrófica, e 3,29%, queloide. Dos 304 pacientes, 26,64% (81) relataram estar satisfeitos e 58,88% (179) relataram estar parcialmente satisfeitos com o resultado. A hipocromia esteve presente em 33,55% (102) dos indivíduos. CONCLUSÕES: O laser Q-switched NdYAG é um método seguro e eficaz, apresentando bom grau de satisfação e poucos efeitos indesejáveis na remoção de tatuagem.

INTRODUCTION: Both dermabrasion and surgery have been used in the practice of tattoo removal. Currently, laser is also being used. The aim of this study is to evaluate tattoo removal with Q-switched Nd:YAG laser. METHOD: This is a retrospective study on patients treated by using Q-switched Nd:YAG laser. The data were collected from medical records and patient photographs, and through phone or e-mail contact. Statistical tests were done through the analysis of distribution, multivariate regression, and logistic regression. RESULTS: A total of 304 patients with an average age of 29.8 years (±7.86 years) were assessed. Of the total, 297 (97.69%) were classified as white (phototypes I, II, and III), 270 (88.81%) of whom had professional tattoos done. The oldest tattoo was 360 months old and the most recent was 1 month old, with an average of 64.56 months (±63.54 months). The tattoo size was, on average, 12.92 cm, with black being the predominant color (i.e., present in 291 [86.51%] tattoos). The average number of sessions per patient was 3.77 (±2.99), and the interval between sessions was 49.23 days. The therapist observed that 52.96% of the tattoos were partially removed, 21.38% were not removed, 86.51% showed normal healing, 8.55% developed a hypertrophic scar, and 3.29% developed a keloid. Of the 304 patients, 81 (26.64%) reported being satisfied and 179 (58.88%) reported being partially satisfied with the outcome. Hypochromia was present in 102 (33.55%) patients. CONCLUSIONS: Q-switched Nd:YAG laser is a safe and effective method for tattoo removal that results in a good degree of patient satisfaction and few undesirable effects.

Técnica simples e segura para a reconstrução areolopapilar com tatuagem intradérmica / Simple and safe technique for nipple-areola reconstruction with intradermal tattoo

INTRODUÇÃO: A reconstrução do complexo areolopapilar (CAP) constitui o passo final na criação da neomama, com o objetivo de aproximá-la da mama contralateral após a mastectomia. A restauração do CAP tem sido historicamente um procedimento feito em estágios, com a reconstrução da papila realizada por meio de enxertos ou retalhos locais, previamente, e da aréola, posteriormente, buscando a coloração adequada. Atualmente, a utilização da tatuagem areolar está alcançando popularidade cada vez maior, comparativamente às técnicas tradicionais. O objetivo deste trabalho é descrever a técnica e os equipamentos utilizados para a tatuagem intradérmica em pacientes mastectomizadas, realizada no Serviço de Cirurgia Plástica e Microcirurgia Reconstrutiva do Hospital Universitário Walter Cantídio (Fortaleza, CE, Brasil). MÉTODO: O presente trabalho descreve os passos para a realização do procedimento reparador utilizando a tatuagem areolar permanente com equipamento convencional de tatuagem artística profissional. O procedimento foi aplicado em 10 pacientes submetidas a reconstrução mamária pós-mastectomia. RESULTADOS: O método demonstrou as vantagens da simplicidade técnica do procedimento, não requerendo internamento nem resultando em morbidade de áreas doadoras. CONCLUSÕES: A tatuagem do CAP é um procedimento seguro, rápido, com baixa morbidade e bons resultados na finalização da reconstrução mamária.

BACKGROUND: The final step in the creation of the neo-breast is reconstruction of the nipple-areolar complex (NAC), which is aimed toward bringing the appearance of the NAC closer to that of the contralateral breast following mastectomy. NAC restoration has historically been a stepwise procedure, in which reconstruction of the nipple by the use of grafts or local flaps was followed by reconstruction of the areola to achieve the correct color. Currently, the popularity of the areolar tattoo is increasing compared to traditional techniques. The aim of this study was to describe the technique and equipment used for intra-dermal tattooing in mastectomized patients at the Plastic Surgery and Reconstructive Microsurgery Service of the Walter Cantídio University Hospital (Fortaleza, CE, Brazil). METHODS: This study describes the steps of the repair procedure by using permanent areolar tattooing with conventional equipment from a professional tattoo artist. The procedure was used in 10 patients undergoing post-mastectomy breast reconstruction. RESULTS: The advantages of this method included the technical simplicity of the procedure, the ability to use this procedure in outpatients, and the lack of morbidity of the donor areas. CONCLUSIONS: Tattooing the NAC is a safe, fast procedure with low morbidity and good results of breast reconstruction.

Tatuajes de henna negra: revisión de la literatura a partir de un caso clínico / Black henna tattoos: case report and review of the literature

En la actualidad los tatuajes de henna negra se utilizan en forma muy frecuente, por lo que el número de reportes sobre reacciones adversas asociadas a su uso se ha incrementado. La Parafenilendiamina o PPD es el químico que más se adiciona a la henna para intensificar y prolongar la duración del color del tatuaje. Posee un gran poder sensibilizante y se le atribuyen la mayoría de las reacciones, desde dermatitis leve hasta reacciones generalizadas tipo eritema multiforme-like. Se presenta el caso de un paciente de 7 años con lesiones cutáneas frente a segunda exposición a tatuaje de henna. Con diagnóstico de dermatitis de contacto se maneja con corticoidestópicos con excelente respuesta clínica. Como prevención primaria planteamos la necesidad de programas que permitan educar a la comunidad en relación a los riesgos asociados a la exposición a PPD, recomendando el NO uso de tatuajes de henna negra.

Today, black henna tattoos are very commonly used, so the number of reports on adverse reactions associated with its use has increased. The paraphenylenediamine or PPD is the chemical that is most commonly added to henna to intensify and prolong the duration of the color tattoo. PPD act as sensitizer of most of the reactions, from mild dermatitis to generalized reactions erythema multiforme-like. We show a case of a 7 year old patient with skin lesions that appears during the second exposure to henna tattoos. We made the diagnosis of a contact dermatitis and we manage it with topical corticosteroids with excellent clinical response. As primary prevention we suggest the need of educational programs for the community regarding the risks associated with the exposure of PPD, and avoiding the use of black henna tattoos.

Tatuajes y "piercing" / Tattoos and piercing

A pesar de estar en el siglo XXI se ha retomado el lenguaje con códigos de comunicación arcaicos. Los jóvenes forman su identidad mediante la interacción con sus pares y los tatuajes y "piercing" tienen sus propios códigos, que son interpretados por el grupo que los lleva. Actualmente los tatuajes y los "piercing" encuentran su lugar predominante en la población adolescente, donde se han reinstalado por ser "moda" y generalmente se aceptan por estar generalizados. Asimismo los observamos en poblaciones marginales: de drogadictos y carcelarias. Realizarse un tatuaje y/o "piercing" implica ciertos riesgos, entre los que podemos mencionar la transmisión de infecciones que pueden ser localizadas en las zonas del tatuaje y/o "piercing"; y/o generalizadas como las virósicas algunas de las cuales conllevan riesgos de salud como el virus del HIV, de las hepatitis A,B,C. Pueden observarse también reacciones alérgicas, de hipersensibilidad, liquenoides, granulomatosas y varias como cicatrices hipertróficas y queloides; asimismo desencadenar un primer episodio de psoriasis, lupus, etc. Dentro de las recomendaciones para informar a la población deberíamos incluir: que las regiones del cuerpo más riesgosas para la realización de los mismos (que debieran evitarse) son aquellas que asientan en cabeza (incluyendo boca, nariz), cuello y órganos genitales. También es importante tener la vacunación antitetánica actualizada, considerar las condiciones de higiene del local donde se va a asistir y el tipo de material a utilizar, debiendo ser en lo posible material descartable. Los cuidados durante los primeros días post práctica son: mantener la zona limpia y seca, baños cortos, secarse sin frotado y no exponerse al sol por tres o cuatro meses. Asimismo es aconsejable ante cualquier reacción concurrir a la consulta profesional.

In spite of being in the XXI century, several archaic codes of communication language have been restablished. Young people form their identity by peer interaction, and tattoos and piercing have their own codes interpreted by the group by whom are exhibited. Nowadays tattoos and piercing have taken their place among adolescents where they have been reinstalled as "fashion" and widely accepted. Also, there are used in marginal populations such as drug users and prison inmates. Having a tattoo and/or piercing implies certain risks among which we are the transition of infectious diseases that could be localized at the site of the tattoo/piercing, or generalized as viral infections such HIV, and hepatitis A, B, or C. Other possible complications are the appearance of allergic, hypersensitivity, lichenoid, and granulomatous reactions, or the triggering of a first episode of psoriasis, lupus, etc. In the recommendations to inform the population we should include that the body regions more unsafe for these practices are: the head (including mouth and nose), neck, and genitalia. Is also very important to have tetanus vaccines updated, considering the hygiene conditions of the tattoo parlor and the quality of the material that is going to be used which should be disposable if possible. The local care in the first days post-practice are: keeping the region clean and dry, short showers, dry without rubbing, and avoid the sun for three or four months. Also is advisable in the case of any reaction seek for professional advice.

Reconstrução do complexo aréolo-mamilar pela técnica do retalho retangular / Nipple-areolar complex reconstruction by a rectangular flap technique

Realizamos um estudo, em 18 pacientes, nas quais foram realizadas 19 reconstruções de placas aréolo-mamilares. O intervalo entre a reconstrução da mama e reconstrução do CAM variou entre 3 meses e 1 ano. Utilizamos a técnica do retalho retangular para reconstruir o mamilo e a tatuagem para a aréola. Avaliando os resultados, observamos que foram ótimos, quanto à manutenção da projeção do mamilo, em 84,2 dos casos, sendo que 3 casos necessitaram de reintervenção. Quanto à aréola, 6 casos foram submetidos à nova sessão de tatuagem, enquanto em 68,4 dos casos o resultado primário foi excelente.

This study was performed in 18 patients, with 19 nipple-areolar complex reconstruction. The interval between breast mound and nipple-areolar reconstruction ranged from 3 months to 1 year. We had used the re- tangular flap to reconstruction of the nipple and tatoo to remake the areola. Observing the final results, we found out excellent nipple projection im 84,2 of the cases (three cases needed reconstruction). In aréola, 6 cases needed to be retatooing, while in 68,4, the results were excellent.