Altuntaş Zeynep Karaçor, Kamburoğlu Haldun Onuralp, Yavuz Nurten, Dadacı Mehmet, İnce Bilsev
Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey.
Aesthetic Plast Surg. 2015 Jun;39(3):325-30. doi: 10.1007/s00266-015-0470-3. Epub 2015 Mar 18.
Proper nipple-areolar complex position in reduction mammoplasty patients is a challenging problem regardless of the preferred technique. Postoperatively, the nipple-areolar complex is often not located at the most projected area of the breast. This retrospective observational study aimed to find the long-term measurements of the nipple-areolar complex position and inferior pole length after inverted T scar-superomedial pedicle reduction mammoplasty.
Forty-eight female patients (96 breasts) were included in this study. The inclusion criteria were that no previous operation should have been done on any of the breasts and both NAC complexes should be at least 30 cm from the midclavicular point. Preoperatively, the distance from the midclavicular point to the new nipple was recorded. All patients were operated on with the inverted T pattern and superomedial pedicle technique. The resection weights, the distance from the midclavicular point to the nipple distance, and the distance from the NAC lower border to the inframammary fold were evaluated postoperatively with an average of 15-month follow-up.
The mean preoperative distance from the midclavicular point to the nipple was 34.21 cm for the right breast and 34.26 cm for the left breast. The mean resection weight per breast was 1035 g for the right breast and 1081 g for the left breast. The descent of the NAC was 1.61 cm for the right breast and 1.79 cm for left breast (mean: 1.7 cm) at the end of the follow-up. Additionally, the inframammary length increased 3.31 cm for the right breast and 3.59 cm for the left breast (mean: 3.45 cm).
In this study, we found that the new nipple-areolar complex does not go upward but goes downward. However, it was not located at the most projected area of the breast as it was set intra-operatively. This was because the lower pole of the breast sagged more than the nipple: clinically, we observed a nipple superior displacement of 1.75 cm (3.45 - 1.7 = 1.75). According to this calculation, we believe that the new nipple position should be marked at 1.5-1.75 cm below the most projected area of the breast after final shaping so that in the long term, the nipple-areolar complex would be at the proper position.
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无论采用何种手术技术，在巨乳缩小术患者中，使乳头乳晕复合体处于合适位置都是一个具有挑战性的问题。术后，乳头乳晕复合体往往并不位于乳房的最突出区域。这项回顾性观察研究旨在探寻采用倒T形切口-乳房上内侧蒂法巨乳缩小术后乳头乳晕复合体位置及乳房下极长度的长期测量结果。
本研究纳入了48例女性患者（96侧乳房）。纳入标准为：任何一侧乳房此前均未接受过手术，且双侧乳头乳晕复合体距锁骨中点至少30 cm。术前记录从锁骨中点到新乳头的距离。所有患者均采用倒T形切口及乳房上内侧蒂技术进行手术。术后平均随访15个月，评估切除重量、从锁骨中点到乳头的距离以及乳头乳晕复合体下缘到乳房下皱襞的距离。
右侧乳房术前从锁骨中点到乳头的平均距离为34.21 cm，左侧乳房为34.26 cm。右侧乳房每侧平均切除重量为1035 g，左侧乳房为1081 g。随访结束时，右侧乳房乳头乳晕复合体下移1.61 cm，左侧乳房下移1.79 cm（平均：1.7 cm）。此外，右侧乳房乳房下皱襞长度增加3.31 cm，左侧乳房增加3.59 cm（平均：3.45 cm）。
在本研究中，我们发现新的乳头乳晕复合体并非向上移动，而是向下移动。然而，它并未如术中设定的那样位于乳房的最突出区域。这是因为乳房下极下垂程度超过了乳头：临床上，我们观察到乳头向上移位了1.75 cm（3.45−1.7 = 1.75）。根据这一计算结果，我们认为在最终塑形后，新乳头位置应标记在乳房最突出区域下方1.5 - 1.75 cm处，以便从长远来看，乳头乳晕复合体能处于合适位置。
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