title: Long-term changes in nipple-areolar complex position and inferior pole length in superomedial pedicle inverted 't' scar reduction mammaplasty.
abstract: BACKGROUND
  Proper nipple-areolar complex position in reduction mammoplasty patients is a challenging problem regardless of the preferred technique. Postoperatively, the nipple-areolar complex is often not located at the most projected area of the breast. This retrospective observational study aimed to find the long-term measurements of the nipple-areolar complex position and inferior pole length after inverted T scar-superomedial pedicle reduction mammoplasty.
  
  
  METHODS
  Forty-eight female patients (96 breasts) were included in this study. The inclusion criteria were that no previous operation should have been done on any of the breasts and both NAC complexes should be at least 30 cm from the midclavicular point. Preoperatively, the distance from the midclavicular point to the new nipple was recorded. All patients were operated on with the inverted T pattern and superomedial pedicle technique. The resection weights, the distance from the midclavicular point to the nipple distance, and the distance from the NAC lower border to the inframammary fold were evaluated postoperatively with an average of 15-month follow-up.
  
  
  RESULTS
  The mean preoperative distance from the midclavicular point to the nipple was 34.21 cm for the right breast and 34.26 cm for the left breast. The mean resection weight per breast was 1035 g for the right breast and 1081 g for the left breast. The descent of the NAC was 1.61 cm for the right breast and 1.79 cm for left breast (mean: 1.7 cm) at the end of the follow-up. Additionally, the inframammary length increased 3.31 cm for the right breast and 3.59 cm for the left breast (mean: 3.45 cm).
  
  
  CONCLUSIONS
  In this study, we found that the new nipple-areolar complex does not go upward but goes downward. However, it was not located at the most projected area of the breast as it was set intra-operatively. This was because the lower pole of the breast sagged more than the nipple: clinically, we observed a nipple superior displacement of 1.75 cm (3.45 - 1.7 = 1.75). According to this calculation, we believe that the new nipple position should be marked at 1.5-1.75 cm below the most projected area of the breast after final shaping so that in the long term, the nipple-areolar complex would be at the proper position.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey.
authors.forename: Zeynep Karaçor
authors.initials: ZK
authors.lastname: Altuntaş
authors.forename: Haldun Onuralp
authors.initials: HO
authors.lastname: Kamburoğlu
authors.forename: Nurten
authors.initials: N
authors.lastname: Yavuz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Dadacı
authors.forename: Bilsev
authors.initials: B
authors.lastname: İnce
mesh_terms: D001940:Breast / Q000473:pathology* / Q000601:surgery*; D002921:Cicatrix / Q000517:prevention & control; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D009558:Nipples / Q000033:anatomy & histology / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014894:Weights and Measures