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The New England Journal of Medicine Jun 2017
Topics: Breast Diseases; Humans; Male; Middle Aged; Nipples; Thrombophlebitis
PubMed: 28591532
DOI: 10.1056/NEJMicm1611550 -
Ugeskrift For Laeger Oct 2016Inverted nipples is an anatomical variation which can be uni- or bilateral, congenital or acquired. The degree of inversion can vary from slight to severe. Treatment can... (Review)
Review
Inverted nipples is an anatomical variation which can be uni- or bilateral, congenital or acquired. The degree of inversion can vary from slight to severe. Treatment can be surgical or non-surgical and should depend on the degree of functional problems. Non-surgical treatment can be beneficial, does not risk affecting sensibility, spares the lactiferous ducts, and therefore does not risk any interference with breast-feeding. Surgical options should only be considered when non-surgical treatment is insufficient.
Topics: Female; Humans; Nipples
PubMed: 27745579
DOI: No ID Found -
Aesthetic Plastic Surgery Oct 2018Breast surgery has long been viewed as an art more than a science. However, defining and objectively measuring the ideal breast morphology and aesthetic proportions are... (Review)
Review
Breast surgery has long been viewed as an art more than a science. However, defining and objectively measuring the ideal breast morphology and aesthetic proportions are fundamental for surgical planning and to setting the goals of surgery as well as to evaluate surgical outcomes. Despite the fact that much has been written about aesthetic and reconstructive breast surgery, there is still no real consensus about what the attributes are of an ideal breast. Moreover, there are in fact no objective standard measurement systems and guidelines to describe ideal or even normal breast shape. Though there is great variability in the perception of beauty among patients and surgeons alike due to many factors among which are age, sex, and sociocultural background, there is common agreement that beauty is a universal phenomenon that has a universal standard present across all civilizations and centuries, and that perceived beauty is enhanced and optimal aesthetics are achieved when proper measurements are made and anthropometric proportions as well as attractive harmonious ratios are respected. The current review is an attempt to summarize the most relevant information available trying to introduce some harmony in our perception of aesthetic ideals of breast surgery. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Anthropometry; Beauty; Breast; Esthetics; Female; Humans; Mammaplasty; Nipples; Reference Standards
PubMed: 30006829
DOI: 10.1007/s00266-018-1154-6 -
Plastic and Reconstructive Surgery Nov 2018
Topics: Mammaplasty; Nipples; Surgical Flaps
PubMed: 30222673
DOI: 10.1097/PRS.0000000000004900 -
Current Problems in Dermatology 2022Cosmetic tattooing dedicated to beautifying the normal anatomy such as the eyebrows, the eyelines, or the lips is in a remarkable growth all over the world. Medical... (Review)
Review
Cosmetic tattooing dedicated to beautifying the normal anatomy such as the eyebrows, the eyelines, or the lips is in a remarkable growth all over the world. Medical tattooing with reconstruction of the areola and the nipple after breast surgery, correction of the lost color of vitiligo and scars is a spin-off, which has made tattooing cross the barrier and become accepted and used in clinics and hospitals in service of the quality of life of patients. The last years have seen a major development of machinery, inks, techniques, experiences, and services. The overwhelming rise of the activity created by client pressure and business opportunity, however, also has its cons: amateur work and even malpractice. The development is driven by elite technicians, but competence is little transparent to clients, and there is no distinct authoritative recognition of practitioners based on a recognized educational curriculum. National regulations of the industry are highly variable and scattered. Some countries have no restriction and in others cosmetic tattoos shall be performed by medical doctors. The challenge of the coming decades is to parallel the success of the industry with quality assurance to better control practices and safeguard clients, and the patients.
Topics: Humans; Tattooing; Quality of Life; Nipples; Mastectomy; Lip
PubMed: 37263214
DOI: 10.1159/000525184 -
Plastic and Reconstructive Surgery Feb 2019The breast and the factors that affect the sensitivity of the nipple-areola complex have been a significant subject of study in recent years. The main purpose of this...
BACKGROUND
The breast and the factors that affect the sensitivity of the nipple-areola complex have been a significant subject of study in recent years. The main purpose of this study was to provide an objective assessment of the effect of volumetric differences on nipple-areola complex sensitivity.
METHODS
Data were collected examining the right breast of 34 female volunteers. The mechanosensitive Aβ-fiber and mechanoinsensitive C-fiber function of the nipple-areola complex was assessed after mechanical and chemical stimulation, respectively. Flare responses were elicited chemically by the application of histamine by means of iontophoresis and recorded by laser Doppler imaging. The correlation of the maximum flare area responses with the breast volume and nipple-areola complex and the response from the von Frey fiber test was estimated using linear regression analysis.
RESULTS
Nipple-areola complex area increased with breast volume and, similarly, the area of histamine-induced axon reflex flare response follows the larger nipple-areola complex. However, a larger nipple-areola complex correlated with higher local mechanical thresholds. Higher mechanical thresholds were linked to smaller axon reflex area, suggesting combined small- and thick-fiber neuropathy.
CONCLUSIONS
Objective small-fiber assessment using laser Doppler imaging and subjective mechanical threshold tests were used successfully to quantify function of Aβ and C fibers in the nipple-areola complex. Increased breast volume was linked to larger nipples, but also to impairment of Aβ and C fibers. Sensory testing can be incorporated into preoperative and postoperative management of patients undergoing breast operations to assess changes of neuronal function of the nipple-areola complex after surgery.
Topics: Adult; Breast; Female; Healthy Volunteers; Humans; Laser-Doppler Flowmetry; Nipples; Reference Values; Sampling Studies; Sensation; Sensory Thresholds; Young Adult
PubMed: 30688881
DOI: 10.1097/PRS.0000000000005200 -
Advances in Experimental Medicine and... 2020Paget's disease of the breast (PDB) is a rare breast carcinoma believed to arise from an underlying in situ or invasive ductal cancer that migrates through the epidermis... (Review)
Review
Paget's disease of the breast (PDB) is a rare breast carcinoma believed to arise from an underlying in situ or invasive ductal cancer that migrates through the epidermis causing characteristic skin changes including scaling, redness, and itching of the nipple, areola, and sometimes the surrounding skin. Although Paget's may mimic benign conditions such as contact or allergic eczema and mastitis, it should remain a strong consideration in the differential diagnosis , especially in peripartum women for whom benign conditions such as bacterial mastitis from breastfeeding are common. The workup of Paget's should focus on both making the diagnosis with nipple/skin scrape cytology or punch biopsy as well as evaluating any underlying mass with mammogram, breast ultrasound , and also a core needle biopsy , if required. Treatment focuses on management of the underlying breast cancer as usual. The purpose of this chapter is to describe the presentation of PDB as well as outline an approach to its diagnosis and management, especially in the setting of pregnancy and lactation.
Topics: Breast Neoplasms; Diagnosis, Differential; Female; Humans; Lactation; Nipples; Paget's Disease, Mammary; Pregnancy; Pregnancy Complications, Neoplastic
PubMed: 32816273
DOI: 10.1007/978-3-030-41596-9_18 -
Aesthetic Plastic Surgery Aug 2021Herniated or pseudoherniated nipple-areolar complex (NAC), also called protuberant or "domed nipple," is an entity that can be present both in males and females and...
BACKGROUND
Herniated or pseudoherniated nipple-areolar complex (NAC), also called protuberant or "domed nipple," is an entity that can be present both in males and females and represents a therapeutic challenge. It can be an isolated deformity, but in most cases is found within another breast deformity, such as tuberous breast or can appear following pregnancy. Its diagnosis and appropriate treatment become important when patients search for correctional breast surgery.
OBJECTIVE
To review some common techniques for the treatment of tuberous breasts that address the nipple-areola problem as well, but also to present our experience with some newer and less invasive surgical techniques that could be useful for isolated treatment of herniated or pseudoherniated nipple.
METHOD
We performed a retrospective study that included all patients operated from December 2013 to December 2018. We reviewed existing techniques which in addition to our personal experience helped us to create an algorithm to assist surgeons in this matter.
RESULTS
A total of 125 patients with herniated or pseudoherniated NAC were treated. There were 87 women and 38 men. The average age of the patients was 30, 8 ± 8.1 years (ranging from 20 to 63). We analyzed the results of four following techniques: periareolar mastopexy (52 patients), release of fibrous tissue in combination with lipofilling (19 patients), resection of herniated breast tissue (23 patients) or controlled electrocoagulation of relaxed erectile muscle (31 patients). The minimum follow-up for all cases was 4 months.
CONCLUSION
The achievement of a successful aesthetic result is possible in a single-stage procedure with initial surgery. It depends on careful individual preoperative evaluation of anatomical features and a surgical approach chosen accordingly.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.
Topics: Adult; Esthetics; Female; Humans; Male; Mammaplasty; Middle Aged; Nipples; Retrospective Studies; Surgical Flaps; Treatment Outcome; Young Adult
PubMed: 33999222
DOI: 10.1007/s00266-021-02308-1 -
The American Journal of Surgical... Aug 2023Nipple adenoma (NA) is a rare, benign proliferation of the nipple ducts. It may be clinically mistaken for Paget disease or squamous cell carcinoma; thus, microscopic...
Nipple adenoma (NA) is a rare, benign proliferation of the nipple ducts. It may be clinically mistaken for Paget disease or squamous cell carcinoma; thus, microscopic evaluation is paramount. A large case series of NA has not been undertaken since the 1980s. Therefore, we undertook this study to evaluate the clinicopathologic characteristics of NA, emphasizing differential diagnoses and follow-up data. We retrieved 50 cases from our in-house archives or consultation files between 2003 and 2022. Available slides were reviewed, and clinical data and follow-up information were obtained. Cases must have exhibited a dense ductal proliferation in the breast tissue with proximity to the nipple epidermis. All patients were women; median age was 56 years. In all, 68% of patients were symptomatic; 53% demonstrated a skin growth. Overall, 67% were excised completely, either primarily (33%) or via re-excision after biopsy (33%). Four histologic patterns were noted: adenosis (dense proliferation of small-to-medium ducts); large duct (medium-to-large caliber ducts); papillary-like (frond-like architecture with branching, slit-like lumens); and pseudoinfiltrative (ducts squished and distorted by dense stromal fibrosis). Follow-up in 44 patients (88%) with a median time of 66 months showed no evidence of recurrence. NA demonstrates a wide spectrum of histopathologic variation. Subtyping of this entity is unlikely to be clinically relevant. Differentiation from invasive carcinoma or other histologic mimics (syringocystadenoma papilliferum, syringomatous adenoma) may be difficult. Simple excision is curative, and recurrence is rare. A definitive link to invasive carcinoma has not been established.
Topics: Humans; Female; Middle Aged; Male; Breast Neoplasms; Adenoma; Nipples; Adenocarcinoma
PubMed: 37272622
DOI: 10.1097/PAS.0000000000002063 -
The Breast Journal Jan 2018
Topics: Adult; Breast Diseases; Conservative Treatment; Female; Humans; Nipples
PubMed: 28590581
DOI: 10.1111/tbj.12838