Improving symmetry of nipple–areola complex (NAC) position in reduction mammoplasty using laser level projection

Holzbach, T.; Linder, Sora; Leitsch, Sebastian; Loucas, Rafael; Loucas, Marios; Giunta, Riccardo E.; Mayer, Julius Michael

doi:10.1016/j.bjps.2022.10.023

Cited by 5 publications

(6 citation statements)

References 27 publications

(45 reference statements)

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“…Different clavicle heights or asymmetrical lengths will affect the MC-to-nipple distance, therefore affecting the symmetry of the new nipple position. Additionally, patients undergoing breast surgery do not tape-measure distances but mainly evaluate the correct nipple position depending on their reflection in the mirror [ 1 , 17 ], consequently focusing on the identical height of the NAC of both breasts.…”

Section: Discussionmentioning

confidence: 99%

“…The SSN-to-nipple distance does not account for a symmetrical nipple height when the NAC is not symmetrically centred in both breasts or if there is a difference in breast width [ 17 ]. Here, the MC-to-nipple distance appears to be a superior measure but is still prone to inaccuracies when there is a difference in clavicle length or clavicle height.…”

Section: Introductionmentioning

confidence: 99%

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How Useful Is the SSN–Nipple Distance? An Analytical Questionnaire Survey on Anthropometric Measurements for the Aesthetically Ideal Positioning of the Nipple–Areolar Complex

Loucas

Leitsch

et al. 2023

JCM

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Several studies have attempted to identify the optimal anthropometric measurement for the aesthetically ideal positioning of the nipple–areolar complex. However, no standardised solutions and measurements for planning surgical procedures have been reached. The aim of this study is to identify the optimal anthropometric measurement between the suprasternal notch (SSN)–nipple distance and mid-clavicle (MC)–nipple distance for the aesthetic position of the nipple–areola complex (NAC) on the breast. A detailed online survey was sent to 300 board-certified plastic surgeons and residents of plastic surgery departments of hospitals in German, Austrian, and Swiss. A similar survey was also provided to 100 patients who had planned or had already undergone breast surgery. All participants were asked to rank the attractiveness of a series of women’s breasts in images with different NAC position measurements. The images showed breasts from two different measurements and distances: all the breasts had equal dimensions and proportions and the same areola size. Complete datasets were obtained from 203 of the 300 board-certified plastic surgeons and residents of plastic surgery departments in German-speaking countries (recall 68%) and from 100 patients. The majority of doctors and patients find a symmetrical breast with a mirrored position of the nipple–areola complex more attractive than a non-symmetrical breast. In cases with minor measurement differences, such as 0.5 cm (SSN vs. MC), there is no relevant difference in the breast symmetry. However, at larger distances, the MC-to-nipple distance is superior for achieving aesthetically appealing symmetry compared with the SSN-to-nipple distance. Using the MC-to-nipple distance seems to be superior for correct nipple positioning than the SSN-to-nipple distance and is a valuable preoperative measurement option for breast symmetry with correct nipple height. Further studies on this topic involving a more general population should be conducted to confirm the improvements in perception with the preoperative measurements using the anatomical landmarks.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

How Useful Is the SSN–Nipple Distance? An Analytical Questionnaire Survey on Anthropometric Measurements for the Aesthetically Ideal Positioning of the Nipple–Areolar Complex

Loucas

Leitsch

et al. 2023

JCM

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“…Precise preoperative markings and appropriate adherence to them during surgery used to be the key elements for achieving postoperative breast volume and symmetry [ 7 , 15 , 16 , 25 , 26 ]. However, evaluating the intraoperative volume seems to play a crucial role in achieving the best possible postoperative aesthetic results [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, evaluating the intraoperative volume seems to play a crucial role in achieving the best possible postoperative aesthetic results [ 35 ]. So far, the intraoperative assessment of breast volume and volume differences mainly relies on the surgeon’s visual estimations, which can be influenced by individual subjective factors [ 15 , 16 ]. Therefore, it is important to use an objective tool such as intraoperative 3D volumetric assessment to ensure symmetrical breast volume.…”

Section: Discussionmentioning

confidence: 99%

“…Breast volume is a crucial factor and a key metric that defines breast symmetry, influencing cosmesis and patient satisfaction after breast surgery [ 1 , 2 , 3 ]. Several objective methods for evaluating breast volume and symmetry are widely used, and these methods are based on linear distances such as anthropometric measurements [ 4 , 5 , 6 , 7 ], volumetric measurements using medical imaging technology [ 8 , 9 , 10 , 11 ], techniques like water displacement [ 12 , 13 , 14 , 15 , 16 ], and casting techniques [ 17 , 18 ]. Three-dimensional (3D) photographic imaging measurements are increasingly gaining a role in breast surgery.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Intraoperative Volumetric Assessment of Breast Volume Using 3D Handheld Stereo Photogrammetric Device

Loucas,

Leitsch

et al. 2023

JPM

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Methods for assessing three-dimensional (3D) breast volume are becoming increasingly popular in breast surgery. However, the precision of intraoperative volumetric assessment is still unclear. Until now, only non-validated scanning systems have been used for intraoperative volumetric analyses. This study aimed to assess the feasibility, handling, and accuracy of a commercially available, validated, and portable device for intraoperative 3D volumetric evaluation. All patients who underwent breast surgery from 2020 to 2022 were identified from our institutional database. Intraoperative 3D volumetric assessments of 103 patients were included in this study. Standardized 3D volumetric measurements were obtained 3 months postoperatively to compare the intraoperatively generated volumetric assessment. All of the study participants were women with a mean age of 48.3 ± 14.7 years (range: 20–89). The mean time for intraoperative volumetric assessment was 8.7 ± 2.6 min. The postoperative 3D volumetric assessment, with a mean volume of 507.11 ± 206.29 cc, showed no significant difference from the intraoperative volumetric measurements of 504.24 ± 276.61 cc (p = 0.68). The mean absolute volume difference between the intraoperative simulations and postoperative results was 27.1 cc. Intraoperative 3D volumetric assessment using the VECTRA H2 imaging system seems to be a feasible, reliable, and accurate method for measuring breast volume. Based on this finding, we plan to investigate whether volumetric objective evaluations will help to improve breast symmetry in the future.

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Letter to the Editor: A new laser level App to improve nipple-areola complex symmetry in breast surgery

Cavaliere,

D’Andrea,

Schonauer

2023

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Improving symmetry of nipple–areola complex (NAC) position in reduction mammoplasty using laser level projection

Cited by 5 publications

References 27 publications

How Useful Is the SSN–Nipple Distance? An Analytical Questionnaire Survey on Anthropometric Measurements for the Aesthetically Ideal Positioning of the Nipple–Areolar Complex

How Useful Is the SSN–Nipple Distance? An Analytical Questionnaire Survey on Anthropometric Measurements for the Aesthetically Ideal Positioning of the Nipple–Areolar Complex

Evaluation of Intraoperative Volumetric Assessment of Breast Volume Using 3D Handheld Stereo Photogrammetric Device

Letter to the Editor: A new laser level App to improve nipple-areola complex symmetry in breast surgery

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