Ibrahim, Ahmed M. S.Sinno, Hani H.Izadpanah, AliVorstenbosch, JoshuaDionisopoulos, TassosMureau, Marc A. M.Tobias, AdamLee, BernardLin, Samuel2015-06-022015Ibrahim, Ahmed M. S., Hani H. Sinno, Ali Izadpanah, Joshua Vorstenbosch, Tassos Dionisopoulos, Marc A. M. Mureau, Adam M. Tobias, Bernard T. Lee, and Samuel J. Lin. 2015. “Nipple-areolar Complex Reconstruction following Postmastectomy Breast Reconstruction: A Comparative Utility Assessment Study.” Plastic and Reconstructive Surgery Global Open 3 (4): e380. doi:10.1097/GOX.0000000000000133. http://dx.doi.org/10.1097/GOX.0000000000000133.2169-7574http://nrs.harvard.edu/urn-3:HUL.InstRepos:16121097Background: Nipple-areola complex (NAC) reconstruction occurs toward the final stage of breast reconstruction; however, not all women follow through with these procedures. The goal of this study was to determine the impact of the health state burden of living with a reconstructed breast before NAC reconstruction. Methods: A sample of the population and medical students at McGill University were recruited to establish the utility scores [visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG)] of living with an NAC deformity. Utility scores for monocular and binocular blindness were determined for validation and comparison. Linear regression and Student’s t test were used for statistical analysis, and significance was set at P < 0.05. Results: There were 103 prospective volunteers included. Utility scores (VAS, TTO, and SG) for NAC deformity were 0.84 ± 0.18, 0.92 ± 0.11, and 0.92 ± 0.11, respectively. Age, gender, and ethnicity were not statistically significant independent predictors of utility scores. Income thresholds of <$10,000 and >$10,000 revealed a statistically significant difference for VAS (P = 0.049) and SG (P = 0.015). Linear regression analysis showed that medical education was directly proportional to the SG and TTO scores (P < 0.05). Conclusions: The absence of NAC in a reconstructed breast can be objectively assessed using utility scores (VAS, 0.84 ± 0.18; TTO, 0.92 ± 0.11; SG, 0.92 ± 0.11). In comparison to prior reported conditions, the quality of life in patients choosing to undergo NAC reconstruction is similar to that of persons living with a nasal deformity or an aging neck requiring rejuvenation.en-USJournal Article2015-06-0210.1097/GOX.0000000000000133