Document Detail

Classification and management of the postoperative, high-riding nipple.
MedLine Citation:
PMID:  23416436     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Postoperative nipple malposition can be an aesthetically devastating problem for patients and a formidable challenge for surgeons. The authors' aim was to identify the common antecedent events leading to high-riding nipples, provide a classification system for these problems, and discuss management.
METHODS: A retrospective review of medical records was conducted for patients who presented to the senior surgeon (S.L.S.) for management of a postoperative, excessively high nipple-areola complex over an 8-year period from January of 2004 to March of 2012. Demographic information, medical histories, operative details, and office records were reviewed for each patient. The high nipple-areola complex was classified as mild, moderate, or severe depending on the distance from the superior breast border to the top of the nipple-areola complex in relation to the vertical breast height.
RESULTS: Twenty-five women met study criteria, with 41 breasts determined to have an excessively high nipple-areola complex. The average patient was aged 44.3 years and had undergone 2.5±1.3 operations before the development of a notably high nipple-areola complex, including nipple-sparing mastectomy (32 percent), augmentation/mastopexy (29 percent), augmentation (27 percent), mastopexy (10 percent), and skin-sparing mastectomy with nipple reconstruction (2 percent). Patients were classified as having mild (27 percent), moderate (56 percent), or severe (17 percent) nipple-areola complex displacement; surgical correction was attempted in 54 percent of cases.
CONCLUSIONS: A high-riding nipple-areola complex can develop following aesthetic or reconstructive surgery. Although many patients may not need or choose correction, there are surgical options that may be helpful in improving the nipple-areola complex position.
Scott L Spear; Frank P Albino; Ali Al-Attar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  131     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-29     Completed Date:  2013-08-02     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1413-21     Citation Subset:  AIM; IM    
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MeSH Terms
Breast Implantation / methods*
Breast Implants*
Breast Neoplasms / surgery
Mammaplasty / methods*
Mastectomy, Segmental
Microsurgery / methods
Middle Aged
Nipples / anatomy & histology,  surgery*
Postoperative Complications / diagnosis*,  surgery*
Retrospective Studies
Surgical Flaps / blood supply
Suture Techniques
Comment In:
Plast Reconstr Surg. 2014 Jan;133(1):64e-6e   [PMID:  24374695 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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