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This pilot study introduces NPAT, a combined approach of nipple punch grafting and 3D areola tattooing, to reconstruct the nipple-areola complex (NAC) after gender-affirming double-incision mastectomy. NPAT demonstrated fewer complications, such as graft failure or hypopigmentation, than free nipple-areola grafting (FNAG). Public evaluation showed NPAT produced significantly better aesthetic ratings across diverse demographic groups.
