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.
Plast Reconstr Surg. 2011 Oct;128(4):984-989. doi: 10.1097/PRS.0b013e3182268d73.
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.
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.
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.
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.
不同的研究已经调查了与美学乳房增大后乳头乳晕复合体敏感性改变相关的解剖和手术因素。作者对大量患者进行了回顾性评估，以评估可能与这些改变相关的风险因素。
从第一作者 2004 年 5 月至 2010 年 9 月的个人档案中回顾性地收集数据。排除的是那些进行了与隆胸不同的手术（即乳房缩小术）、与可能影响乳头乳晕复合体的其他手术（如乳房提升术、乳头提升术、乳头内陷、乳头缩小术、包膜切除术）相关的隆胸术、乳房修复术、乳房植入物置换术或单侧或不对称的隆胸术。
研究纳入的患者人数为 1222 例。唯一与乳头乳晕复合体敏感性改变和乳晕疼痛相关的 6 个月时的因素是皮肤切口的类型。乳晕切口比乳晕下切口更常见术后乳头乳晕复合体敏感性改变（卡方检验，p=0.001）。乳晕切口使乳头乳晕复合体敏感性改变的风险增加近三倍，乳晕疼痛的风险增加三倍以上。
用于隆胸的皮肤切口类型似乎会影响术后乳头乳晕复合体敏感性改变或乳晕疼痛的发生。尽管这影响了一小部分患者，但值得一提，以便能够更清晰地获得知情同意和对手术的同意。
临床问题/证据水平：治疗，III。
