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Vertical Scar Reduction Mammaplasty: The Fate of Nipple-Areola Complex Position and Inferior Pole Length

Ahmad, Jamil M.D.; Lista, Frank M.D.

Plastic and Reconstructive Surgery: April 2008 - Volume 121 - Issue 4 - p 1084-1091
doi: 10.1097/01.prs.0000302453.26842.5d
BREAST: ORIGINAL ARTICLES
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Background: A major advantage of vertical scar reduction mammaplasty is the improved long-term projection of the breasts. In their experience with more than 1700 cases, the authors have observed the following important trends: Postoperatively, the nipple-areola complex is located higher than one would predict from the preoperative skin markings, and pseudoptosis does not occur. This study was performed to provide objective measurements to confirm these observations.

Methods: Forty-nine consecutive women had the following measurements taken of their right breast preoperatively and on postoperative day 5: distance from the clavicle to the superior border of the nipple-areola complex; the clavicle to the nipple; and the inframammary crease to the inferior border of the nipple-areola complex. Forty-six women were available for follow-up at 4 years, and measurements were repeated.

Results: Compared with preoperative skin markings, the nipple-areola complex was located on average 1.3 cm higher on postoperative day 5 and 1.0 cm higher at 4-year follow-up. The average distance from the inframammary crease to the inferior border of the nipple-areola complex had decreased 0.4 cm at 4-year follow-up.

Conclusions: Compared with preoperative skin markings, the nipple-areola complex was located significantly higher at both early and long-term follow-up. The authors have adjusted their skin marking technique so that the superior border of the nipple-areola complex is marked at the level of the inframammary crease. At 4 years, the distance from the inframammary crease to the inferior border of the nipple-areola complex was significantly shorter, and pseudoptosis did not occur after vertical scar reduction mammaplasty.

Dallas, Texas; and Mississauga, Ontario, Canada

From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; the Plastic Surgery Clinic; and the Division of Plastic Surgery, Trillium Health Center.

Disclosure:Neither of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article.

Received for publication June 18, 2007; accepted August 1, 2007.

Presented at the 61st Annual Meeting of the Canadian Society of Plastic Surgeons, in Banff, Alberta, Canada, June 2, 2007.

Frank Lista, M.D.; The Plastic Surgery Clinic; 1421 Hurontario Street; Mississauga L5G 3H5, Ontario, Canada; drlista@theplasticsurgeryclinic.com

©2008American Society of Plastic Surgeons