Impact of nipple-areola complex micropigmentation on body image and psychosocial outcomes after breast reconstruction: A nursing-led advanced practice approach.

PURPOSE: Nipple-areola complex (NAC) micropigmentation is increasingly integrated into breast reconstruction, however standardized evidence regarding its psychosocial impact remains limited. This study aimed to evaluate the holistic effect of NAC micropigmentation on body image, psychosocial and sexual well-being, and aesthetic satisfaction, while assessing the quality of nurse-led advanced practice care. METHODS: A multicentre, observational study was conducted across four Spanish hospitals using a pre-post design with comparable cohorts. Data were collected using the Body Image Scale (BIS) and the BREAST-Q questionnaire. The study rigorously addresses previous methodological gaps by utilizing validated tools to evaluate real-life patient impact. RESULTS: Two hundred and eighty-three patients who underwent NAC micropigmentation significantly improved their body image and psychosocial well-being. Notable enhancements were observed in highly vulnerable post-mastectomy dimensions, such as body-related shame, scar dissatisfaction and sexual perception of the reconstructed breast (p < 0.05). Almost 66% of the patients reported high aesthetic satisfaction, reinforcing the intervention's role in achieving reconstructive completeness. Nurse-led approach was highly valued, achieving 98.5% patient endorsement rate. CONCLUSION: NAC micropigmentation is a low-risk, high-impact intervention that effectively reduces body image related distress and enhances sexual well-being. When performed by advanced practice nurses, it integrates technical expertise with humanized care, optimizing oncological recovery. These findings support the systematic inclusion of nurse-led micropigmentation within multidisciplinary breast reconstruction protocols as an essential component of patient-centered care.