Computer-assisted evaluation of nipple-areola complex sensibility in macromastia and following superolateral pedicle reduction mammaplasty: a statistical analysis.
BACKGROUND
The authors performed a prospective study quantifying nipple-areola complex sensibility by computer-assisted neurosensory testing in breast hypertrophy before and after superolateral breast reduction.


METHODS
A superolateral pedicle breast reduction was performed on 30 macromastia patients. The mean age of the patients was 46 years. The cup sizes of the patients were as follows: D, 14 patients; E, 12 patients; and EE, four patients. Ptosis was 3 degrees in 12 and 4 degrees in 18; nipple elevation ranged from 4 to 18 cm; glandular resection ranged from 379 to 1850 g. Static and moving one- and two-point discrimination was tested preoperatively and 6 months postoperatively at the nipple-areola complex, evaluating the impact of breast hypertrophy (D versus E and EE cups), nipple elevation (<9 cm versus > or =9 cm), and glandular resection (<900 g versus > or =900 g).


RESULTS
Statistical analyses revealed preoperatively significant higher pressure thresholds in the nipple-areola complex of larger versus smaller hypertrophies and in the nipple of longer nipple-areola complex transposition breasts for static and moving one-point discrimination. Postoperatively, worsening of sensibility was more significant in the nipple-areola complex of smaller versus larger hypertrophies and of shorter versus longer nipple-areola complex transposition breasts for moving one-point discrimination.


CONCLUSIONS
This study confirms that macromastia patients present a reduced breast sensibility, which is not necessarily worsened by reduction mammaplasty. After reduction mammaplasty with the superolateral pedicle technique, nipple-areola complex sensibility might be slightly reduced, which is less detectable in large-breast hypertrophy because of lower preoperative levels of sensibility and less of a postoperative decrease.
Santanelli
Fabio
F
Rome, Italy From the Plastic Surgery Unit, Sant'Andrea Hospital, Second School of Medicine, and Department of Experimental Medicine and Pathology, First School of Medicine, University of Rome "La Sapienza."
Paolini
Guido
G
Bittarelli
Delio
D
Nofroni
Italo
I
D000328:Adult; D001940:Breast / Q000473:pathology* / Q000601:surgery; D003936:Diagnosis, Computer-Assisted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000473:pathology / Q000601:surgery; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000294:innervation*; D011182:Postoperative Care; D011300:Preoperative Care; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D012677:Sensation / Q000502:physiology; D012684:Sensory Thresholds; D018709:Statistics, Nonparametric; D016896:Treatment Outcome