MPS  Vol.12 No.3 , July 2022
Upper Footprint Dependent Nipple Position to Avoid High-Riding Nipple after Reduction Mammoplasty
Abstract: Introduction: High-riding nipple following reduction mammoplasty is a challenging problem for the plastic surgeons. To avoid such problem, many methods have been described for marking the correct nipple position but still controversial. We aimed in this study to present our experience in preventing excessive nipple elevation after reduction mammoplasty by using the upper footprint to set the new nipple position. Material and Methods: From March 2019 to March 2022, 25 female patients at a mean age of 38.3 years were included in this prospective study. They underwent reduction mammoplasty with inverted T scar and a combination of inferior pedicle and Würinger’s septum techniques. Resection weights, pre- and postoperative anthropometric measures were recorded. All patients were photographed at the follow-up visits and evaluated for complications if any, the nipple-areola complex (NAC) sensation, and subjective patient satisfaction using “The Breast Evaluation Questionnaire”. Results: The mean preoperative midclavicular point to nipple distance was 37.40 and 37.18 cm for the right and left breasts, respectively. The mean resection weight was 1270 and 1242 g from the right and left sides, respectively. None of our patients experienced NAC necrosis, while 2 breasts had minor wound dehiscence treated conservatively. After a mean follow-up period of 12 months, the NAC descended by an average of 1.40 cm, the distance from the IMF to nipple had an average increase of 2.24 cm, and all of patients were satisfied with the esthetic outcomes and convinced with their breast shape. Conclusion: The upper footprint dependent nipple position seems to have a real role in preventing high-riding nipple after breast reduction in hypertrophic and gigantomastic breasts. Moreover, it can be applied easily and allow for more satisfying outcomes than other methods for setting the new nipple position.
Cite this paper: Mahmoud, W. , Homouda, W. , Elghazaly, M. and Khedr, M. (2022) Upper Footprint Dependent Nipple Position to Avoid High-Riding Nipple after Reduction Mammoplasty. Modern Plastic Surgery, 12, 42-49. doi: 10.4236/mps.2022.123004.

[1]   Colwell, A.S., May Jr., J.W. and Slavin, S.A. (2007) Lowering the Postoperative High-Riding Nipple. Plastic and Reconstructive Surgery, 120, 596-599.

[2]   Frenkiel, B.A., Pacifico, M.D., Ritz, M. and Southwick, G. (2010) A Solution to the High-Riding Nipple-Areola Complex. Aesthetic Plastic Surgery, 34, 525-527.

[3]   Altuntaş, Z.K., Kamburoğlu, H.O., Yavuz, N., Dadacı, M. and İnce, B. (2015) Long-Term Changes in Nipple-Areolar Complex Position and Inferior Pole Length in Superomedial Pedicle Inverted “t” Scar Reduction Mammaplasty. Aesthetic Plastic Surgery, 39, 325-330.

[4]   Lewin, R., Widmark-Jensen, E., Plate, N. and Hansson, E. (2018) Objective Evaluation of Nipple Position after 336 Breast Reductions. Journal of Plastic Surgery and Hand Surgery, 52, 198-203.

[5]   Blondeel, P.N., Hijjawi, J., Depypere, H., Roche, N. and Van Landuyt, K. (2009) Shaping the Breast in Aesthetic and Reconstructive Breast Surgery: An Easy Three-Step Principle. Plastic and Reconstructive Surgery, 123, 455-462.

[6]   Lassus, C. and Hidalgo, D.A. (1999) Update on Vertical Mammaplasty. Plastic and Reconstructive Surgery, 104, 2303-2304.

[7]   Ahmad, J. and Lista, F. (2008) Vertical Scar Reduction Mammaplasty: The Fate of Nipple-Areola Complex Position and Inferior Pole Length. Plastic and Reconstructive Surgery, 121, 1084-1091.

[8]   Spear, S.L. and Albino, F.P. (2016) Management of the High-Riding Nipple after Breast Reduction. Clinics in Plastic Surgery, 43, 395-401.

[9]   Souza, A.A., Faiwichow, L., Ferreira, Á.D.A., Simão, T.S., Pitol, D.N. and Máximo, F.R. (2011) Comparative Analysis of Mammaplasty Techniques Based on the Long-Term Effect on the Nipple-Areolar-Complex to Inframammary Crease Distance. Revista Brasileira de Cirurgia Plástica, 26, 664-669.

[10]   Gulyás, G. (2004) Marking the Position of the Nipple-Areola Complex for Mastopexy and Breast Reduction Surgery. Plastic and Reconstructive Surgery, 113, 2085-2090.

[11]   Hall-Findlay, E.J. (2004) Vertical Breast Reduction. Seminars in Plastic Surgery, 18, 211-224.

[12]   Akyurek, M. (2011) Contouring the Inferior Pole of the Breast in Vertical Mammaplasty: Suction-Assisted Lipectomy versus Direct Defatting. Plastic and Reconstructive Surgery, 127, 1314-1322.

[13]   Kelahmetoglu, O., Firinciogullari, R., Yagmur, C., Yildiz, K. and Guneren, E. (2017) Combination of Würinger’s Horizontal Septum and Inferior Pedicle Techniques to Increase Nipple-Areolar Complex Viability during Breast Reduction Surgery. Aesthetic Plastic Surgery, 41, 1311-1317.

[14]   Portincasa, A., Ciancio, F., Cagiano, L., Innocenti, A. and Parisi, D. (2017) Septum-Enhanced Mammaplasty in Inferocentral Pedicled Breast Reduction for Macromastia and Gigantomastia Patients. Aesthetic Plastic Surgery, 41, 1037-1044.

[15]   Pennington, D.G. (2006) Improving the Results of Inferior Pedicle Breast Reduction Using Pedicle Suspension and Plication. Aesthetic Plastic Surgery, 30, 390-394.