Breast Asymmetries: A Working Formulation
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Left breast
Areola
Background: Circumareolar incisions in breast augmentation surgery can center slightly low areolas on the breast mound and treat moderate ptosis. This maneuver, however, is limited to moderate cases because it does not achieve any lifting of the breast. Objectives: The author describes periareolar augmentation mastopexy (PAM), a new systematic approach of breast augmentation and lifting through a circumareolar incision, by means of a vertical or T-plication on the lower pole of the breast. Methods: Twenty-eight patients underwent PAM. Intraoperatively, the epidermis was stripped on the area between the areola and the circumareolar incisions; after abundant tumescent infiltration, a detachment was performed on the areolar plane at the breast's lower pole. The submuscular plane was reached through a vertical incision on the breast, and a high-profile implant was placed. Over the same incision, a strong plication was performed to tighten the laxity causing the ptosis. The skin was closed with a purse-string suture. Results: The complication rate was low in this patient series: one case of small necrosis of the periareolar skin, one case of areolar asymmetry, three cases in which the areolas were not postoperatively round, and one case of infection in the unilateral purse-string suture. All patients saw great improvement in breast shape and were satisfied with ptosis correction. The technique results in minimal postoperative scarring, since it relies on a single circumareolar incision. Conclusions: In this small series, PAM proved to be an excellent technique with consistent aesthetic results for correction of hypomastia in patients with moderate to minimally severe ptosis. Level of Evidence: 4
Mastopexy
Areola
Breast reduction
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Mastopexy
Areola
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A young woman, health, 33 years old presented unilateral areola nipple pruritus and burning about one month ago. She denies smoking or drinking alcoolics bevareges. The initial diagnosis was dermatitis and she was treated with topical regimes. She sought further evaluation and care at our institution. Further investigation revealed breast cancer behind the left nipple and areola. She underwent to Breast-Conserving Surgery (BCS) to the left areola and nipple with sentinel Lymph Node Biopsy (SND) negative. The margins were clear achieved. The surgery for reconstructive breast was Grisotti’s technic. The adjuvant radiotherapy was used.
Areola
Adjuvant radiotherapy
Left breast
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Mastopexy
Areola
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More than 300,0000 breast plastic surgery procedures are performed annually worldwide, of which more than 100,000 are reduction mammoplasties carried out in the United States. Although most patients tend to be satisfied with the immediate outcomes of this procedure, there is increasing concern among surgeons as well as patients with regard to breast sensibility and the postoperative recovery.The objectives of this study were to assess the variation in the sensibility in patients undergoing hypertrophic breast surgery by quantification of the impact of various variables and to evaluate its progression from before the surgery to between 3 and 6 months and 1 year postoperatively.We carried out a nonrandomized, monocentric, prospective study. All of the patients were examined by the same evaluator using a set of 20 von Frey monofilaments on the day before the surgery and at 3 to 6 months and 1 year postoperatively. The breast skin, areola, and nipple sensibilities were tested. Age, body mass index, tobacco use, and the breast volume were recorded.We did not find any significant effect of the body mass index, tobacco use, or age on breast sensibility. The nipple and areola complex (NAC) sensibility was inversely correlated with the degree of hypertrophy before the surgery, but this difference disappeared in the postoperative evaluations. After the surgery, the NAC sensibility decreased at the first follow-up at 4.5 months and returned to normal after 1 year.The inverse relationship between breast volume and sensibility in the preoperative evaluation disappeared after mammaplasty reduction. In the early postoperative period, the sensibility decreased on the NAC but returned to normal after 1 year.
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This case is of interest only because of the extremely rapid growth of a large breast tumor in a girl, aged 14 years. While the Cohnhein theory of the origin of such tumors arising from misplaced islands of tissue is in many instances doubted, it is difficult to explain this case on any of the other theories. This girl had normal appearing, symmetrical breasts with no evidence of nodule formation in February 1935. Sometime during April she began experiencing a "heaviness" of the right breast and noted that the nipple areola on this side appeared wider. Sometime in May she noticed that the entire right breast was larger than the left, and the "feeling of heaviness" was increased. For relief her mother made her a "carrier" to help support this breast. From this time on the breast grew very rapidly. Within two months from the time the patient first complained
Girl
Areola
Right breast
Left breast
Nodule (geology)
Breast tissue
Breast tumor
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Objective To observe the clinical effect of breast surgery through areola incision. Methods 94 patients with breast disease admitted in our hospital from April 2011 to April 2013 were selected as subjects and they were divided into the research group(n=47) and the control group(n=47) according to the principle of voluntariness in patients.The research group was given breast surgery through areola incision while the control group was given surgical procedures through incision of other parts.The clinical effect and patients ′ satisfaction were comparedof the two groups. Results The rate of lesion clearance(P0.05) and patients′ satisfaction(P0.01) were higher that in the control group. Conclusion Breast surgery through areola incision treating breast disease has good clinical effect and it is worthy of clinical reference.
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Surgical incision
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Breast reduction
Mastopexy
Areola
Neurovascular bundle
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Objective To seek an effective surgical procedure to treat patients with the varying degrees of breast ptosis and micromastia.Methods Patients were classified into Ⅰ-Ⅳ degrees based on different breast ptosis,and treated by different methods.Degree Ⅰ was treated with implanting prosthesis to the post-pectoralis major space; degree Ⅱ patients were repaired with avulsion of deeper mammary gland and pectoralis major and hanging fixed breast tissue,based on the degree Ⅰ procedure; degree Ⅲ was fixed with breast tissue flap,excised redundant epidermis by the method of double-rings and the complex of nipple and areola was shifted,based on the degree Ⅱ procedure; degree Ⅳ was repaired with implanting prosthesis and the method of lines to hanging fixed breast.Results In 116 cases of this study,there were no hematoma,infection and nipple and areola necrosis by the combined strategies.The follow-up period after the surgery was 6-31 months (mean 13.3 months).All cases had voluptuous and upright breasts,rectified breast ptosis,with the normal sense of nipple and areola.Conclusions For breast ptosis and hypoplasia,the combined strategies have better clinical therapeutic effects.
Key words:
Mammaplasty breast; Breast ptosis; Micromastia; Prosthesis implantation
Areola
Inframammary fold
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