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Aesthetic Repair of Nipple and Areolar Abnormalities

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Breast Surgery

Abstract

Introduction: The nipple–areola complex (NAC) is an essential structure of the mammary anatomy. Concerning breast oncology, NAC reconstruction represents an important stage to the patient from an aesthetic point of view. Patient perception and the proportion of the NAC in relation to the breast shape are fundamental to the patient’s self-esteem.

Method: This is a descriptive chapter based on a literature review and demonstration of the techniques developed and performed at the Faculdade de Medicina de Marilia’s Serviço de Cirurgia Plástica, São Paulo, Brazil (FAMEMA). The complications related to the procedures used to rebuild or repair the NAC are dyschromia, low sensitivity, infections, necrosis, and the partial or full recurrence of the inverted nipple.

Conclusion: These deformities and their respective corrections must be known by plastic surgeons, thus allowing them to correct or even ease those pathological conditions.

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References

  • Adams WM (1949) Labial transplant for correction of loss of the nipple. Plast Reconstr Surg 4:295

    Article  CAS  Google Scholar 

  • Benelli L (1988) Technique de plastie mammaire le round block. Rev Fr Chir Esth 13(50):7–11

    Google Scholar 

  • Chang YC (2007) Aesthetic surgery for hypertrophic nipple: a simple technique. Rev Soc Bras Cir Plást 22(1):30–33

    Google Scholar 

  • Di Lamartine J, Cintra Junior R, Daher JC, Cammarota MC, Galdino J, Pedroso DB, Cintra RH (2013) Nipple-areola reconstruction using the double opposing flap technique. Rev Bras Cir Plást 28(2):233–240

    Article  Google Scholar 

  • Elliott LF, Hartrampf CR Jr (1990) Breast reconstruction: progress in the past decade. World J Surg 14(6):763–775

    Article  CAS  PubMed  Google Scholar 

  • Evans KK, Rasko Y, Lenert J et al (2005) The use of calcium hydroxylapatite for nipple projection after failed nipple-areolar reconstruction: early results. Ann Plast Surg 55:252-259;discussion 29

    Google Scholar 

  • Fanous N, Tawile C, Fanous A (2009) Nipple reduction—an adjunct to augmentation mammoplasty. Can J Plast Surg 17(3):81–88

    Article  PubMed  PubMed Central  Google Scholar 

  • Farhadi J, Maksvytyte GK, Schaefer DJ, Pierer G, Scheufler O (2006) Reconstruction of the nipple-areola complex: an update. J Plast Reconstr Aesthet Surg 59(1):40–53

    Article  PubMed  Google Scholar 

  • Ferreira LM, Neto MS, Okamoto RH, Andrews J d M (1995) Surgical correction of nipple hypertrophy. Plast Reconstr Surg 95:753–754

    Article  CAS  PubMed  Google Scholar 

  • Few JW, Marcus JR, Casas LA et al (1999) Long-term predictable nipple projection following reconstruction. Plast Reconstr Surg 104:1321–1324

    Article  CAS  PubMed  Google Scholar 

  • Han S, Hong YG (1999) The inverted nipple: its grading and surgical correction. Plast Reconstr Surg 104(2):389–395

    Article  CAS  PubMed  Google Scholar 

  • Lai Y, Wu C (1996) Nipple reduction with a modified circumcision technique. Br J Plast Surg 49:307–309

    Article  CAS  PubMed  Google Scholar 

  • Lai YL, Weng CJ, Samuel Noordhoft M (1998) Areolar reduction with inner doughnut incision. Plast Reconstr Surg 101:1695–1699

    Article  CAS  PubMed  Google Scholar 

  • Lewis JR Jr (1973) Atlas of aesthetic plastic surgery. In: Cap 10: Breasts, 1st edn. Little, Brown and Company, Boston, p 231

    Google Scholar 

  • Neligan PC (2013) Plastic surgery. In: Pate KM, Nahabedian MY (eds) Cap 22, Nipple aréola complex reconstruction, vol 5, 3rd edn. Elsevier, Philadelphia, p 500

    Google Scholar 

  • Pereira Filho OJ, Bins-Ely J, Granemann AS et al (2001) Closed inverted nipple treatment through a microincision procedure. Plast Reconstr Surg 108:1000–1005

    Article  CAS  PubMed  Google Scholar 

  • Pitanguy I (1978) Mamaplastia. Guanabara Koogan, Rio de Janeiro

    Google Scholar 

  • Pitanguy I, Macareno A (1975) Reconstrução de aréola e mamilo. Rev Bras Cir 65(9/10):237–244

    Google Scholar 

  • Regnault P (1975) Nipple hypertrophy. A physiology reduction by circumcision. Clin Plast Surg 2:391–396

    CAS  PubMed  Google Scholar 

  • Riot S, Devinck F, Aljudaibi N, Duquennoy-Martinot V, Guerreschi P (2015) Tatouage de la plaque aréolo-mammelonnaire en reconstruction mammaire: note technique. Ann Chir Plast Esthet 61:141–144

    Article  PubMed  Google Scholar 

  • Saad JF (2001) Reconstrução do complexo aréolo-papilar com retalho em fechadura associado à pigmentação com tatuagem [dissertação de mestrado]. Universidade de São Paulo, Faculdade de Medicina, São Paulo, p 102

    Google Scholar 

  • Schwartz AW (1976) Reconstruction of the nipple and areola. Br J Plast Surg 29:230–233

    Article  CAS  PubMed  Google Scholar 

  • Sisti A, Grimaldi L, Tassinari J, Cuomo R, Fortezza L, Bocchiott MA, Roviello F, D’Aniello C, Nisi G (2016) Nipple-areola complex reconstruction techniques: a literature review. EJSO 42:441–465

    Article  CAS  PubMed  Google Scholar 

  • Sperli AE (1974) Cosmetic reduction of the nipple with functional preservation. Br J Plast Surg 27:42–43

    Article  CAS  PubMed  Google Scholar 

  • Spina V (1950) Neo-areoplasty with labial transplant: symmetrical correction of shape and volume of breast. Plast Reconstr Surg 6:400

    Article  CAS  Google Scholar 

  • Vecchione TR (1979) The reduction of the hypertrophic nipple. Aesthet Plast Surg 3:343–345

    Article  CAS  Google Scholar 

  • Wexler MR, Oneal RM (1973) Areola sharing to reconstruct the absent nipple. Plast Reconstr Surg 51:115

    Article  Google Scholar 

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Correspondence to Helio Paoliello Jr. .

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Paoliello, H., Paoliello, R. (2018). Aesthetic Repair of Nipple and Areolar Abnormalities. In: Avelar, J. (eds) Breast Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-54115-0_47

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  • DOI: https://doi.org/10.1007/978-3-319-54115-0_47

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