Khan Umar Daraz
Belvedere Private Hospital, Knee Hill Abbeywood, London, SE2-0GD, UK.
Aesthetic Plast Surg. 2009 Jul;33(4):591-6. doi: 10.1007/s00266-009-9324-1. Epub 2009 Mar 19.
Nipple-areola complex (NAC) lateralisation in the horizontal axis is understudied with respect to its potential effects on the outcome of augmentation mammoplasty. An implant pocket dissected slightly laterally on the affected side offsets the lateralised nipple and improves the quality of breast enhancement in the lateral quadrant with an aesthetically positioned NAC. It also prevents the appearance of medially malplaced implants.
Medial and lateral halves of breasts were measured in 312 mammaplasties performed by the author in 2007; of these, 39 (12%) had NAC asymmetrically positioned in the horizontal plane, 29 (9%) were right lateralised, 4 (1.2%) left lateralised, 5 (1.5%) bilaterally lateralised, and 1 (0.3%) was bilaterally medialised. In the more common right-lateralised group (n = 25), the mean medial half measurement was 8.76 +/- 1.22 cm compared with 8.96 cm in the control group (n = 170), with no statistical significance (P = 0.45). However, the lateral half measurement in the lateralised nipple group (n = 25) was 9.06 +/- 1.53 cm compared with 9.7 +/- 1.67 cm in the control group (n = 169) and it showed a borderline significant value (P = 0.06). On the affected side, the medial boundary of the breast pocket is marked 0.25-0.5 cm further away from the routine 2.5-cm intermammary distance with the goal of offsetting the lateralised NAC and to improve its visual aesthetic position on the breast.
Lateralisation of the breast pocket in a breast with a lateralised nipple improves the aesthetic position of the NAC. In compensated augmentation mammaplasties, lateral quadrant enhancement of the breast is aesthetically superior to uncompensated cases and prevents the appearance of medially malplaced implants. The intermammary distance in compensated cases was acceptable without any compromise to the aesthetic outcome.
乳头乳晕复合体（NAC）在水平轴上的侧偏情况，其对隆乳术效果的潜在影响尚未得到充分研究。在患侧稍向外侧解剖植入腔隙可使侧偏的乳头复位，并在美学定位的NAC情况下改善乳房外侧象限的隆乳质量。这也可防止植入物出现内侧移位的情况。
作者在2007年进行的312例乳房整形手术中测量了乳房的内侧和外侧半部分；其中，39例（12%）的NAC在水平面内位置不对称，29例（9%）向右偏侧，4例（1.2%）向左偏侧，5例（1.5%）双侧偏侧，1例（0.3%）双侧向内侧偏。在更常见的右侧偏侧组（n = 25）中，平均内侧半部分测量值为8.76 +/- 1.22厘米，而对照组（n = 170）为8.96厘米，无统计学意义（P = 0.45）。然而，偏侧乳头组（n = 25）的外侧半部分测量值为9.06 +/- 1.53厘米，而对照组（n = 169）为9.7 +/- 1.67厘米，显示出临界显著值（P = 0.06）。在患侧，乳房腔隙的内侧边界标记在比常规2.5厘米乳房间距远0.25 - 0.5厘米处，目的是使偏侧的NAC复位，并改善其在乳房上的视觉美学位置。
乳头偏侧的乳房中，乳房腔隙的侧偏可改善NAC的美学位置。在代偿性隆乳术中，乳房外侧象限的隆乳在美学上优于非代偿性病例，并可防止植入物出现内侧移位的情况。代偿性病例中的乳房间距是可接受的，且对美学效果没有任何影响。
