Aesthetic Plastic Surgery

, Volume 33, Issue 4, pp 591–596 | Cite as

Breast Augmentation in Asymmetrically Placed Nipple-Areola Complex in the Horizontal Axis: Lateralisation of Implant Pocket to Offset Lateralised Nipples

  • Umar Daraz KhanEmail author
Original Article



Nipple-areola complex (NAC) lateralisation in the horizontal axis is understudied with respect to its potential effects on the outcome of augmentation mammoplasty. An implant pocket dissected slightly laterally on the affected side offsets the lateralised nipple and improves the quality of breast enhancement in the lateral quadrant with an aesthetically positioned NAC. It also prevents the appearance of medially malplaced implants.


Medial and lateral halves of breasts were measured in 312 mammaplasties performed by the author in 2007; of these, 39 (12%) had NAC asymmetrically positioned in the horizontal plane, 29 (9%) were right lateralised, 4 (1.2%) left lateralised, 5 (1.5%) bilaterally lateralised, and 1 (0.3%) was bilaterally medialised. In the more common right-lateralised group (n = 25), the mean medial half measurement was 8.76 ± 1.22 cm compared with 8.96 cm in the control group (n = 170), with no statistical significance (P = 0.45). However, the lateral half measurement in the lateralised nipple group (n = 25) was 9.06 ± 1.53 cm compared with 9.7 ± 1.67 cm in the control group (n = 169) and it showed a borderline significant value (P = 0.06). On the affected side, the medial boundary of the breast pocket is marked 0.25–0.5 cm further away from the routine 2.5-cm intermammary distance with the goal of offsetting the lateralised NAC and to improve its visual aesthetic position on the breast.

Results and Conclusion

Lateralisation of the breast pocket in a breast with a lateralised nipple improves the aesthetic position of the NAC. In compensated augmentation mammaplasties, lateral quadrant enhancement of the breast is aesthetically superior to uncompensated cases and prevents the appearance of medially malplaced implants. The intermammary distance in compensated cases was acceptable without any compromise to the aesthetic outcome.


Muscle-splitting biplane augmentation Lateral quadrant enhancement Breast asymmetry Breast morphometry 



Statistical analysis was done by Dr. Amir Omair, Fatima Memorial Hospital and Medical College, Lahore, Pakistan. I thank Dr. Thomas M. Biggs for his continuous support and ideas. The inception of this article was one of them.


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Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2009

Authors and Affiliations

  1. 1.Belvedere Private HospitalLondonUK

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