-
Plastic and Reconstructive Surgery Mar 2018After studying this article, the participant should be able to: 1. Understand how to determine nipple-areola complex positioning on the reconstructed breast. 2....
LEARNING OBJECTIVES
After studying this article, the participant should be able to: 1. Understand how to determine nipple-areola complex positioning on the reconstructed breast. 2. Understand the multitude of local flap and distant graft options for nipple-areola complex reconstruction. 3. Draw at least three fundamental nipple-areola complex reconstruction patterns. 4. Understand the forces that are responsible for flattening of the reconstructed papule. 5. Understand the current techniques used in secondary nipple-areola complex reconstructions.
SUMMARY
Nipple-areola complex reconstruction and tattooing represent the final two stages of breast reconstruction. Nipple-areola complex reconstruction is typically accomplished with the use of local flaps, local flaps with augmentation grafts, or a combination thereof. Regardless of the technique used, however, all nipple-areola complex reconstructions lose a degree of projection over time. Options for secondary reconstruction include the use of local tissue flaps alone or in combination with acellular biological matrices.
Topics: Female; Humans; Mammaplasty; Nipples; Skin Transplantation; Surgical Flaps; Tattooing
PubMed: 29481412
DOI: 10.1097/PRS.0000000000004166 -
Annales de Chirurgie Plastique Et... Nov 2022THE NIPPLE-AREOLA COMPLEX, ALSO KNOWN AS THE NIPPLE-AREOLA PLATE, IS AN ESSENTIAL VISUAL FEATURE OF THE BREAST.THIS COMPLEX CAN BE AFFECTED BY VARIOUS MALFORMATIONS,...
THE NIPPLE-AREOLA COMPLEX, ALSO KNOWN AS THE NIPPLE-AREOLA PLATE, IS AN ESSENTIAL VISUAL FEATURE OF THE BREAST.THIS COMPLEX CAN BE AFFECTED BY VARIOUS MALFORMATIONS, BOTH CONGENITAL AND ACQUIRED. ALTHOUGH THESE ANOMALIES OFTEN HAVE A MODERATE IMPACT ON THE FUNCTIONALITY OF THIS COMPLEX, THE RESULTING PSYCHOLOGICAL CONSEQUENCES CAN BE SIGNIFICANT. THEIR TREATMENT IS MOST OFTEN SURGICAL AND MANY TECHNIQUES HAVE BEEN DESCRIBED OVER THE YEARS TO RECONSTRUCT AREOLA AND NIPPLE. REGARDLESS OF THE TECHNIQUE USED, THIS ONE AS TO BE SIMPLE, QUICK, IMITATE AS CLOSELY AS POSSIBLE A NATIVE AREOLA-NIPPLE COMPLEX AND BE RELATIVELY DURABLE, AVOIDING NUMEROUS SURGICAL PROCEDURES.: .
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Nipples
PubMed: 36028409
DOI: 10.1016/j.anplas.2022.06.013 -
Current Problems in Dermatology 2022Medical tattoos are used for camouflage of a wide range of disfiguring skin pathologies and conditions. Recently, tattooing of the nipple and areola of the breast has... (Review)
Review
Medical tattoos are used for camouflage of a wide range of disfiguring skin pathologies and conditions. Recently, tattooing of the nipple and areola of the breast has been introduced as a corrective treatment of sequelae from breast cancer surgery and radiotherapy. The psychologic impact of a disfigured nipple and areola can invalidate self-esteem of the sufferer lifelong with major consequences for social life. Medical tattooing can often restore the visual appearance of the nipple-areolar complex back to normality and even improve the 3D impression of the entire breast. High skills of the operator are needed. The article reviews the theoretical background, patient selection and information, technical performance, and aftercare. Close cooperation between surgeon, dermatologist, and medical tattooist is essential. Medical centers treating breast cancer should routinely have access to corrective medical tattooing.
Topics: Humans; Female; Mammaplasty; Breast Neoplasms; Nipples; Mastectomy; Tattooing; Carcinoma, Ductal, Breast
PubMed: 37263222
DOI: 10.1159/000526195 -
Medicina (Kaunas, Lithuania) Jun 2020The reconstruction of the nipple-areola complex is the last step in the breast reconstruction process. Several techniques have been described over the years. The aim of... (Review)
Review
The reconstruction of the nipple-areola complex is the last step in the breast reconstruction process. Several techniques have been described over the years. The aim of this review is to provide clarity on the currently available reconstructive options.
Topics: Adult; Breast Neoplasms; Female; Humans; Mastectomy; Middle Aged; Nipples; Plastic Surgery Procedures; Surgical Flaps
PubMed: 32560062
DOI: 10.3390/medicina56060296 -
Annales de Chirurgie Plastique Et... Jun 2018
Topics: Cartilage; Mammaplasty; Nipples; Prostheses and Implants; Ribs
PubMed: 29625760
DOI: 10.1016/j.anplas.2018.03.002 -
Breastfeeding Medicine : the Official... Jun 2022Nipple dimensions may be an important factor in breastfeeding (BF) initiation success. To establish standards of nipple/areola dimensions in early BF and to determine...
Nipple dimensions may be an important factor in breastfeeding (BF) initiation success. To establish standards of nipple/areola dimensions in early BF and to determine whether maternal age, gestational age (GA), parity, cup size, previous BF experience, and early (<2 hours) BF affect nipple dimensions (assessed on the second day of BF). A total of 205 consecutive BF women were enrolled. They were all Caucasians, and had uncomplicated pregnancies, labors, and vertex vaginal deliveries. Measurements (immediately before and after BF) of nipple length and diameter and of prefeeding areolas were by sliding calipers. In average, there were no significant differences between right (R) and left (L) side dimensions, except for post-BF nipple length, and post-BF horizontal nipple diameter (significantly higher on the L side). Both R and L nipple length correlated positively with maternal age, gravidity, parity, number of previously breastfed infants, and cumulative number of BF months. Early (<2 hours) first BF did not correlate with increased nipple length. Pre-BF nipple length correlated significantly with post-BF nipple length on both sides. There were significant differences between pre- and post- BF values in terms of nipple length (longer length post-BF), but not in terms of nipple diameter. In stepwise regression analysis, where pre-BF nipple length was the dependent variable, and parity (or maternal age, or previous BF), early first BF, and GA were independent variables, parity, maternal age, gravidity, or previous BF experience were positively and significantly associated with nipple length ( < 0.001). The correlation maternal age-nipple length remained significant in primigravida mothers. This study provided a set of standards for nipple and areola dimensions on day 2 of BF in Caucasian women. The only areola/nipple dimension significantly affected by BF is the nipple length. Increasing parity, maternal age, or previous BF experience is significantly associated with increased nipple length.
Topics: Breast Feeding; Female; Humans; Infant; Mothers; Nipples; Parity; Pregnancy
PubMed: 35687116
DOI: 10.1089/bfm.2021.0265 -
Clinics in Plastic Surgery Apr 2016Recurrent or persistent macromastia can occur after breast reduction. This may be due to inadequate primary volume reduction, poor postoperative shape, and breast or... (Review)
Review
Recurrent or persistent macromastia can occur after breast reduction. This may be due to inadequate primary volume reduction, poor postoperative shape, and breast or nipple-areola complex asymmetry. Postpartum breast changes, weight change, and aging can also contribute to recurrent macromastia. The concern in these cases is the altered blood supply to the nipple-areola complex and the safety of nipple-areola complex transposition. Literature on the safety of repeated breast reduction is limited with conflicting approaches. This article discusses an approach to recurrent or persistent macromastia and outlines a modified breast reduction technique that is safe in cases of repeated breast reduction.
Topics: Breast; Female; Humans; Hypertrophy; Mammaplasty; Nipples; Recurrence
PubMed: 27012797
DOI: 10.1016/j.cps.2015.12.004 -
Clinical Radiology Mar 2021The nipple-areolar complex can be affected by a variety of benign and malignant entities that can present with non-specific symptoms. Benign pathologies commonly... (Review)
Review
The nipple-areolar complex can be affected by a variety of benign and malignant entities that can present with non-specific symptoms. Benign pathologies commonly affecting the nipple-areolar complex include nipple calcifications, nipple adenoma, abscess of Montgomery tubercles, ductal ectasia, periductal mastitis, and papilloma. Malignant pathologies that affect the nipple-areolar complex include Paget's disease of the breast, ductal carcinoma in-situ, and invasive ductal carcinoma. Clinical history and examination, imaging, and tissue sampling when appropriate are co-dependent factors that guide the assessment of nipple-areolar pathologies. This article provides a review of the normal anatomy, common anatomical variants, benign and malignant pathologies, and imaging techniques to guide the diagnostic assessment of the nipple-areolar complex.
Topics: Breast Diseases; Diagnostic Imaging; Female; Humans; Nipples
PubMed: 33077158
DOI: 10.1016/j.crad.2020.09.013 -
Annals of Plastic Surgery Jun 2023In breast reconstruction, mastopexy, and breast reduction procedures, surgeons make decisions about the resulting areola size, and this significantly impacts the overall...
BACKGROUND
In breast reconstruction, mastopexy, and breast reduction procedures, surgeons make decisions about the resulting areola size, and this significantly impacts the overall aesthetic result. Despite the importance of these decisions, little is known about the general population's preferences for areola size. The objective of this study was to survey the global population to better understand the public's perceptions of ideal areola dimensions.
METHODS
A survey was developed with 9 different composite diagrams of a female torso (every combination of 3 breast widths and 3 waist widths). In each composite diagram, 6 different areola sizes were shown (areola-to-breast diameter ranging from 1:12 to 6:12). The survey was distributed via the Amazon Mechanical Turk digital platform, and respondents' demographics (sex, age, race/ethnicity, country, and state if located in the United States) and preferences for the most aesthetically pleasing size in each composite diagram were recorded.
RESULTS
Among 2259 participants, with 1283 male (56.8%) and 976 female (43.2%), most participants were between 25 and 34 years old (1012, 44.8%), were from the United States (1669, 73.9%), and identified as White (1430, 63.3%). With 9 breast width and waist width combinations, the respondents were most likely to prefer the 2:12 (32.9%) areola-to-breast ratio ( P < 0.0001). The second most commonly preferred ratio was 3:12 (30.6%) ( P < 0.0001). Gender subgroup analysis showed that women preferred middle-range ratios, such as 2:12, 3:12, and 4:12 ( P < 0.0001). Meanwhile, men were more likely to prefer extreme ratios of 1:12 or 6:12 ( P < 0.0001). Across almost all races/ethnicities, 2:12 was significantly the most popular, except among American Indian/Alaskan Native and Middle Eastern where 3:12 was the most preferred ( P < 0.0001). Within the top 6 countries (United States, India, Brazil, Italy, Canada, United Kingdom), the United States, India, and Italy preferred 2:12, and Brazil, Canada, and the United Kingdom preferred 3:12 ( P < 0.0001).
CONCLUSIONS
This study provides the first objective data on public impressions of the ideal areola proportions and can serve as a guide for surgical decision making in breast reconstruction and reshaping procedures.
Topics: Adult; Female; Humans; Male; Ethnicity; Mammaplasty; Nipples; Plastic Surgery Procedures; Public Opinion; United States; Esthetics
PubMed: 36752529
DOI: 10.1097/SAP.0000000000003407 -
The Surgical Clinics of North America Dec 2022There are many dermatologic conditions that can involve the skin of the breast including malignancy, infections, and inflammatory conditions. These are summarized here... (Review)
Review
There are many dermatologic conditions that can involve the skin of the breast including malignancy, infections, and inflammatory conditions. These are summarized here including presentation and management options.
Topics: Humans; Female; Nipples; Skin; Breast Neoplasms; Breast; Mammaplasty
PubMed: 36335924
DOI: 10.1016/j.suc.2022.07.003