title: Sensitivity of the nipple-areola complex and areolar pain following aesthetic breast augmentation in a retrospective series of 1200 patients: periareolar versus submammary incision.
abstract: BACKGROUND
  Different studies have investigated the anatomical and operative factors associated with alterations of nipple-areola complex sensitivity after aesthetic breast augmentation. The authors conducted a retrospective evaluation of a large series of patients to assess the risk factors that could be associated with such alterations.
  
  
  METHODS
  Data were collected retrospectively from the personal archive of the first author from May of 2004 to September of 2010. Excluded were those that underwent operations on the breast different from augmentation (i.e., breast reductions), augmentations associated with other operations that could influence the nipple-areola complex (e.g., mastopexy, lifting of the nipple, inverted nipple, reduction of the nipple, capsulectomy), breast revisions, breast implant replacements, or monolateral or nonsymmetrical augmentations.
  
  
  RESULTS
  The number of patients included in the study was 1222. The only factor associated with nipple-areola complex sensitivity alterations and areolar pain at 6 months was the type of skin incision used. Alterations were more present postoperatively with the periareolar than with the submammary incision (chi-square test, p=0.001). The periareolar incision increased the risk of nipple-areola complex sensitivity alterations almost threefold and the risk of areolar pain by more than threefold.
  
  
  CONCLUSIONS
  The type of skin incision adopted for breast augmentation seems to influence the occurrence of postoperative nipple-areola complex alterations of sensitivity or areolar pain. Although this affects a small percentage of patients, it is worth mentioning so that a more lucid informed consent and agreement to the operation can be achieved.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Rome, Italy; and Leicester, United Kingdom From Concordia Hospital; the Department of Surgery and the Department of Human Physiology, Laboratory of Biometry, University of Tor Vergata; and the Department of Upper Gastrointestinal Surgery, Leicester Royal Infirmary.
authors.forename: Antonino
authors.initials: A
authors.lastname: Araco
authors.forename: Francesco
authors.initials: F
authors.lastname: Araco
authors.forename: Roberto
authors.initials: R
authors.lastname: Sorge
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Gravante
mesh_terms: D000328:Adult; D017677:Age Distribution; D018427:Breast Implants / Q000009:adverse effects*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016462:Mammaplasty / Q000009:adverse effects* / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery*; D010147:Pain Measurement; D017288:Pain Threshold; D010149:Postoperative Pain / Q000175:diagnosis* / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome