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Sensitivity of the Nipple-Areola Complex and Areolar Pain following Aesthetic Breast Augmentation in a Retrospective Series of 1200 Patients: Periareolar versus Submammary Incision

Araco, Antonino M.D.; Araco, Francesco M.D.; Sorge, Roberto Ph.D.; Gravante, Gianpiero M.D.

Plastic and Reconstructive Surgery: October 2011 - Volume 128 - Issue 4 - p 984–989
doi: 10.1097/PRS.0b013e3182268d73
Cosmetic: Original Articles
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Background: Different studies have investigated the anatomical and operative factors associated with alterations of nipple-areola complex sensitivity after aesthetic breast augmentation. The authors conducted a retrospective evaluation of a large series of patients to assess the risk factors that could be associated with such alterations.

Methods: Data were collected retrospectively from the personal archive of the first author from May of 2004 to September of 2010. Excluded were those that underwent operations on the breast different from augmentation (i.e., breast reductions), augmentations associated with other operations that could influence the nipple-areola complex (e.g., mastopexy, lifting of the nipple, inverted nipple, reduction of the nipple, capsulectomy), breast revisions, breast implant replacements, or monolateral or nonsymmetrical augmentations.

Results: The number of patients included in the study was 1222. The only factor associated with nipple-areola complex sensitivity alterations and areolar pain at 6 months was the type of skin incision used. Alterations were more present postoperatively with the periareolar than with the submammary incision (chi-square test, p = 0.001). The periareolar incision increased the risk of nipple-areola complex sensitivity alterations almost threefold and the risk of areolar pain by more than threefold.

Conclusions: The type of skin incision adopted for breast augmentation seems to influence the occurrence of postoperative nipple-areola complex alterations of sensitivity or areolar pain. Although this affects a small percentage of patients, it is worth mentioning so that a more lucid informed consent and agreement to the operation can be achieved.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Rome, Italy; and Leicester, United Kingdom

From Concordia Hospital; the Department of Surgery and the Department of Human Physiology, Laboratory of Biometry, University of Tor Vergata; and the Department of Upper Gastrointestinal Surgery, Leicester Royal Infirmary.

Received for publication December 8, 2010; accepted March 8, 2011.

Disclosure:The authors have no financial interest to declare in relation to the content of this article. No outside funding was received.

Araco Antonino, M.D.; Via Appia Nuova 206, 00183 Roma, Italy, aracoantonino@hotmail.it

©2011American Society of Plastic Surgeons