Morphologic Study of Nipple-Areola Complex in 600 Breasts

Abstract

To investigate the morphologic characteristics of the nipple-areola complex, the diameter of the nipple-areola complex and the height of the nipple in 300 adult women (600 breasts) were measured using micrometer calipers. Furthermore, the morphologic characteristics were classified into four types by visual observation. Mean diameter of the areola was 4.0 cm, mean diameter of the nipple was 1.3 cm, and mean height of the nipple was 0.9 cm. From the morphologic point of view, the elevated plateau type without constriction (IIs) was most commonly found, being present in 60.2% of breasts. Inverted nipples (III) were found in 3.5% and unclassified type (IV) such as multiple or divided nipples was found in 0.3%. Because women have become sensitive about the appearance of their breasts and there is increasing cosmetic interest following surgery for breast carcinoma, operations on the nipple-areola complex are now common. When a surgeon counsels a patient and designs a reconstruction method prior to operation, these data may be helpful.

The Acellular Dermal Matrix Onlay Graft for Areolar Reconstruction

“…8,9 We present a series of 19 patients, totaling 24 nipple-areolar reconstructions using acellular dermal matrix as an onlay graft. 5Y7 When a tight skin envelope respective to implant size exists, this closure can distort the reconstructed breast.…”

Repair and prevention of nipple inversion following central duct resection utilizing a subcutaneous adipose flap from mammary preglandular tissue

“…From a clinical point of view the nipple invagination is a common problem in female breasts with a reported average frequency of 3.5% within a range of occurrence between 2% and 10% . Sometimes the nipple inversion is due to malignancy, most often it is an acquired condition secondary to inflammatory processes (ductal ectasia, postsurgery, fibrocystic changes, fat necrosis, periductal mastitis) .…”

“…Sometimes the nipple inversion is due to malignancy, most often it is an acquired condition secondary to inflammatory processes (ductal ectasia, postsurgery, fibrocystic changes, fat necrosis, periductal mastitis) . The failure of the underlying mesenchyme to proliferate and the shortened undeveloped breast ducts combined with resistant collagen fibers are the main causes reported for the occurrence of inverted nipples, classified as nipple‐type III . An extensive release (surgical or with needle) of the fibrous tissue beneath the nipple, thereby damaging the lactiferous ducts, has often been suggested to repair the higher degree of nipple inversion categorized as II‐III grade in the Han and Hog classification .…”

“…This SCAF‐based technique has been thought especially for the repair and the reconstruction of nipples with a width of the base at least larger than 1 cm, therefore for women with nipple diameter in the upper range of values widely observed . The proposed technique was applied to 10 cases: two inverted nipples with recurrent abscesses and fistula after puerperal mastitis (Figure A), one inverted nipple with recurrent abscesses after surgery for a fibroadenoma of the central quadrant (Figure D); the other seven patients suffered from ductal papillomatosis associated with bloody discharge.…”

Is periareolar incision a suitable option for breast surgery? A mathematical comparison between periareolar and inframammary fold approaches

“…Since anatomically the mean areolar diameter range is 4-5.25 cm 34,35 and recent algorithms define an areola of 3 cm diameter as small, a hemiperiareolar access of 4.71 cm might be of particular interest in this sort of patients, for the safe insertion of a silicone implant.…”