title: The triple-flap nipple-reduction technique.
abstract: BACKGROUND
  Pure nipple hypertrophy (macrothelia) is a known but rare condition. Nevertheless, minor disproportions between nipple diameter or height and the areola are quite common. During breast surgery, the surgeon often faces the patient's wish to perform nipple reduction. However the methods described are difficult or have drawbacks. This article proposes a simple technique for both height and diameter, or height only, nipple reduction.
  
  
  METHODS
  A technique consisting of the creation of 3 symmetrical triangular flaps in a "Y" fashion and excision of the core of the nipple was performed on 15 consecutive patients between 2001 and 2004. The esthetic results, scars, sensibility, erectility, and complications were evaluated.
  
  
  RESULTS
  All patients presented good to excellent esthetic results, with inconspicuous scars. No major complications occurred in this series. Erectility function of the nipple was preserved in all 15 patients, which is a significant difference when compared with previously published techniques. Alterations in sensibility were temporary and were comparable with summarized alterations in representative published clinical series of both breast reduction and augmentation.
  
  
  CONCLUSIONS
  The triple-flap nipple-reduction technique has the advantage of feasibility, applicable in both height and diameter nipple hypertrophy, with excellent esthetic results and the preservation of both sensibility and erectility.
authors.affiliation: Ivo Pitanguy Institute, Department of Plastic Surgery, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Filipe V
authors.initials: FV
authors.lastname: Basile
authors.forename: Yung C
authors.initials: YC
authors.lastname: Chang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery*; D013524:Surgical Flaps