Septum-Based Mammaplasties: Surgical Techniques and Evaluation of Nipple–Areola Sensibility

Longo, Benedetto; Timmermans, Floyd W.; Farcomeni, Alessio; Frattaroli, Jacopo Maria; D’Orsi, Gennaro; Atzeni, Matteo; Sorotos, Michail; Laporta, Rosaria; Pompeo, Fabio Santanelli di

doi:10.1007/s00266-020-01657-7

Cited by 14 publications

(12 citation statements)

References 27 publications

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“…There are some drawbacks of these tools, e.g., dependence on the skill of the user and the quality and maintenance of the product [26,27]. There are data showing that normal breast sensibility using Semmes-Weinstein nylon monofilaments yields results varying by a magnitude that exceeds 10-fold and that computed devices (Pressure-Specified Sensory Devices) provide results with significantly higher inter-observer reliability [12,28]. However, there are also studies suggesting that monofilaments, if used precisely and adequately, retain the advantages of being an evidence-based, reproducible, affordable, accessible tool for assessing touching sensibility [25,27,[29][30][31].…”

Section: Discussionmentioning

confidence: 99%

The Assessment of Nipple Areola Complex Sensation with Semmes-Weinstein Monofilaments—Normative Values and Its Covariates

et al. 2021

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Objective: To establish normative data for nipple-areola complex (NAC) sensibility examined with Semmes-Weinstein monofilament test (SWMT) and two-point discrimination (TPD) in women with varying breast sizes, including women with gigantomastia. We also aimed to identify clinical variables influencing NAC sensation. Methods: A total of 320 breasts in 160 Caucasian women (mean age 33.6 years, SD 11 years) were examined (including 50 hypertrophic breasts). NACs sensation was examined using Semmes-Weinstein monofilaments (SWM) and the Weber Two-Point Discrimination Test. Results: The nipple appeared to be the most sensitive part of NAC. In normal-sized breasts, sensation thresholds (SWM) correlated with: age, BMI, history of births, breast size and ptosis (for all locations), breastfeeding history (for nipple and upper areola) and areola diameter (for all locations apart from the nipple). Regression analysis showed that age, cup size and suprasternal notch-to-nipple distance are risk factors for diminished NAC sensation. Sensation thresholds in all NAC locations of hypertrophic breasts were significantly higher compared to normal-sized breasts, while TPD tests did not differ between the groups. Conclusions: We provided normative values of NAC sensation (tactile threshold and TPD) for different NAC areas. Our investigation indicated that SWM are useful diagnostic tools when the following factors are considered while examining NAC sensation: location (nipple vs. areola), age, breast size, suprasternal notch-to-nipple distance, history of births and breastfeeding. Hypertrophic breasts presented significantly higher sensation thresholds for all NAC locations. The report may serve as a reference data for further investigations regarding NAC sensation after different breast surgeries.

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Section: Discussionmentioning

confidence: 99%

The Assessment of Nipple Areola Complex Sensation with Semmes-Weinstein Monofilaments—Normative Values and Its Covariates

et al. 2021

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“…Moreover, it ensures a more inferior-central pedicle. 19 On the other hand, Ümran et al showed that there are no statistically significant differences between the inferior and superomedial pedicle. 20 In our study, a majority of the patients retained sensation or regained it within first 6months during the post-operative period.…”

Section: Discussionmentioning

confidence: 98%

Superomedial Pedicle Septum based Reduction Mammoplasty for Breast Hypertrophy

Alkharasan¹,

Hameed²

2022

IqNJM

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Background: Reduction mammoplasty is a technique used for treating women with breast hypertrophy, in addition to improving the appearance of these breasts. Hence, the corrections under this mammoplasty include functional and aesthetic outcomes, while preserving the vascularity and sensibility of the breasts. Aim : To evaluate superomedial septal-based reduction mammoplasty in patients with breast hypertrophy on Nipple Areola Complex (NAC) vascularity, sensibility and overall complications. Patients and Methods: A total of 29 patients with bilateral breast hypertrophy underwent reduction mammoplasty with the superomedial pedicle and septal perforated technique. The mean distance of SN-N was 36.9 cm on the right side and 37.4 cm on the left side. The mean distance transfer of nipple–areola was 18.2 cm for the right side and 18 cm for the left side. The mean excised tissue was 1283 g from the right side and 1240 g from the left side. Results: Postoperatively, the mean of SN-N was 21.5 cm for both the right and left side. A limited wound dehiscence occurred in four patients (13.8%), impaired nipple sensation occurred in three patients (10.1%), while infection was found in one patient (3.4%). Conclusions: In our study, using the superomedial pedicle and septal perforator provided a safe and reliable technique for treating patients with breast hypertrophy, including macromastia and gigantomastia. It minimized the risk of vascular compromise of the NAC. this technique was found to show minor complications and provide good aesthetic outcomes.

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“…We found a greater number of contralateral balancing in group A (43.7% versus 25.0%; P = 0.264), probably because of the need of the patient who has already undergone a mastectomy to reach a complete and more pleasant result. 45 The small sample size is a limitation of the study, which was found to be not powered to identify differences regarding aesthetic evaluation based on post hoc analysis. Nevertheless, an aesthetic analysis of the two groups was also performed along with the analysis of the clinical results.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Secondary breast reconstruction in small to medium-sized irradiated breasts: could Fat-Augmented LD (FALD) flap be a reliable alternative?

Longo

D’Orsi

Vanni

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Secondary breast reconstruction (BR) is recognized as a challenging procedure, particularly when radiotherapy (RT) has previously been performed. The aim of this study was to compare operative data and aesthetic outcomes between secondary irradiated and immediate BR using the fat-augmented latissimus dorsi (FALD) flap. Methods: The authors conducted a prospective clinical study between September of 2020 and September of 2021. Patients were divided into two groups: group A included secondary BR using the FALD flap in previously irradiated breasts, and group B included immediate BR with the FALD flap. Demographics and surgical data were compared, and an aesthetic analysis was performed. Chi-square and t tests were performed for categorical and continuous variables, respectively. Results: Twenty cases of FALD flap-based BR for each group were included. The two groups were found to be homogeneous for the demographic variables. The difference in mean operative time (263.1 minutes versus 265.1 minutes; P = 0.467) and complications (P = 0.633) between the two groups were not significant. There was statistically significant difference in term of immediate fat grafting volume in favor of group A (218.2 cc versus 133.0 cc; P < 0.0001). Regarding aesthetic outcomes, the mean global score evaluation showed no statistically significant differences between groups (17.86 versus 18.21; P = 0.209). Conclusions:The authors' study states that the FALD flap can be considered a reliable procedure for secondary reconstruction in previously irradiated breasts, although it is not indicated for patients with larger breasts. This surgical technique allowed us to achieve a totally autologous BR with good aesthetic results and low complication rates, even in secondary irradiated cases. (Plast.

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Septum-Based Mammaplasties: Surgical Techniques and Evaluation of Nipple–Areola Sensibility

Cited by 14 publications

References 27 publications

The Assessment of Nipple Areola Complex Sensation with Semmes-Weinstein Monofilaments—Normative Values and Its Covariates

The Assessment of Nipple Areola Complex Sensation with Semmes-Weinstein Monofilaments—Normative Values and Its Covariates

Superomedial Pedicle Septum based Reduction Mammoplasty for Breast Hypertrophy

Secondary breast reconstruction in small to medium-sized irradiated breasts: could Fat-Augmented LD (FALD) flap be a reliable alternative?

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