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The Surgical Clinics of North America Dec 2022Peripheral nonlactational abscesses behave like other soft tissue abscesses and resolve with drainage and antibiotics. Subareolar abscesses tend to recur or develop... (Review)
Review
Peripheral nonlactational abscesses behave like other soft tissue abscesses and resolve with drainage and antibiotics. Subareolar abscesses tend to recur or develop fistulae between obstructed ducts and the border of the areola and are usually seen in women in their thirties who have a history of smoking or a congenitally cleft nipple. The underlying cause of subareolar abscesses and fistulae is the obstruction of terminal ducts due to keratin plugging caused by squamous metaplasia of the ducts. Successful resolution of the problem requires excision of the terminal ducts in and just below the nipple along with the correction of nipple deformity, if present.
Topics: Female; Humans; Abscess; Mastitis; Breast Diseases; Nipples; Fistula
PubMed: 36335928
DOI: 10.1016/j.suc.2022.06.007 -
Plastic and Reconstructive Surgery Feb 2020After reading this article, the participant should be able to: 1. Understand the indications for implant-based breast reconstruction and the indications for nipple...
LEARNING OBJECTIVES
After reading this article, the participant should be able to: 1. Understand the indications for implant-based breast reconstruction and the indications for nipple preservation compared to skin-sparing or skin-reducing patterns. 2. Understand the indications for direct-to-implant breast reconstruction versus tissue expander/implant breast reconstruction and the advantages and disadvantages of total, partial, or no muscle coverage. 3. Understand the role of acellular dermal matrix or mesh in reconstruction. 4. Learn the advantages and disadvantages of different types and styles of implants and develop a postoperative plan for care and pain management.
SUMMARY
Breast reconstruction with implants has seen a decade of advances leading to more natural breast reconstructions and lower rates of complications.
Topics: Breast Implantation; Breast Implants; Female; Humans; Mammaplasty; Nipples
PubMed: 31985660
DOI: 10.1097/PRS.0000000000006510 -
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 -
Clinics in Plastic Surgery Apr 2022Contemporary management of gynecomastia includes transareolar excision of gland, disruption of inframammary fold, ultrasonic-assisted lipoplasty with muscular... (Review)
Review
Contemporary management of gynecomastia includes transareolar excision of gland, disruption of inframammary fold, ultrasonic-assisted lipoplasty with muscular definition, bipolar radiofrequency tightening, pedicled NAC mastopexy with boomerang pattern excision and J torsoplasty, NAC grafts with hockey stick excision pattern, and pectoralis muscle lipoaugmentation. Therapeutic options are arranged across a modified Simon classification. The aesthetic goal is near total glandular reduction, with proper position and shape of the nipple areolar complexes, and masculinity with skin adherence reflecting musculoskeleton. Clinical cases demonstrate these multiple approaches, successes, and pitfalls. Complications relate to delayed healing caused by excessive closure tension or inadequate or inappropriate treatment.
Topics: Gynecomastia; Humans; Lipectomy; Male; Mammaplasty; Nipples; Treatment Outcome
PubMed: 35367036
DOI: 10.1016/j.cps.2021.12.003 -
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 -
The Surgical Clinics of North America Feb 2023As breast oncologic surgical procedures and approaches have evolved in recent years, so have breast reconstruction techniques. Newer advances focus on expanding the... (Review)
Review
As breast oncologic surgical procedures and approaches have evolved in recent years, so have breast reconstruction techniques. Newer advances focus on expanding the options of reconstructive approaches and patient selection, optimizing quality of life, and helping improve postsurgical survivorship. These advances span from techniques to expand criteria for nipple-sparing mastectomies, optimizing and enhancing oncoplastic surgery, evolving autologous reconstruction options, and preserving and restoring sensation after mastectomy.
Topics: Humans; Female; Mastectomy; Nipples; Quality of Life; Breast Neoplasms; Mammaplasty
PubMed: 36410346
DOI: 10.1016/j.suc.2022.08.008 -
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 -
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