Atiyeh Bishara S, Dibo Saad A, El Chafic Abdul Hamid
Division Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Ann Plast Surg. 2009 Nov;63(5):499-502. doi: 10.1097/SAP.0b013e3181953854.
After massive weight loss, male breasts in particular are one of the most disturbing body regions and can be a difficult area to treat often requiring nipple-areola repositioning. The need for bilateral repositioning of the nipple-areola complex is also increasing in other surgical fields such as in female-to-male transsexual patients with large breasts and in patients with severe forms of gynecomastia. Proper configuration and localization of the nipple-areola complex requires both meticulous planning and a thorough understanding of the male anatomy and is essential in determining final aesthetic outcome. Currently available guidelines create areolas that are too large, place the nipple-areola complex too high and too far medially, and/or require complex abstract mathematical calculations. Relying on the recently appreciated aesthetic value of the golden number Phi (phi) we propose an easy and reliable method to determine the horizontal and vertical coordinates of the male nipples. With only 2 easily measurable distances, umbilicus-anterior axillary fold apex and umbilicus-suprasternal notch, the internipple distance and the position of the horizontal nipple plane relative to the suprasternal notch can be calculated. The internipple distance can be determined with 95% accuracy and the distance from the suprasternal notch can be determined in 80% of cases within a range of 3.33 +/- 1.25 cm.
在大幅减重后，男性胸部尤其是最令人困扰的身体部位之一，并且可能是一个难以治疗的区域，通常需要乳头乳晕重新定位。在其他外科领域，如乳房较大的女性向男性变性患者以及患有严重男性乳房肥大症的患者中，双侧乳头乳晕复合体重新定位的需求也在增加。乳头乳晕复合体的正确形态和定位需要精心规划以及对男性解剖结构的透彻理解，这对于确定最终美学效果至关重要。目前可用的指导方针所形成的乳晕过大，乳头乳晕复合体位置过高且过于偏内侧，和/或需要复杂的抽象数学计算。基于最近认识到的黄金分割数Phi（φ）的美学价值，我们提出一种简单可靠的方法来确定男性乳头的水平和垂直坐标。仅通过两个易于测量的距离，即脐 - 腋前襞顶点和脐 - 胸骨上切迹，就可以计算出乳头间距以及乳头水平平面相对于胸骨上切迹的位置。乳头间距的确定准确率可达95%，在80%的病例中，相对于胸骨上切迹的距离可在3.33±1.25厘米的范围内确定。
