title: Correlation between nipple elevation and breast resection weight: How to preoperatively plan breast reduction.
abstract: Breast hypertrophy is often associated with functional limitations. Beyond the aesthetic concerns, breast reduction can improve symptoms and self-esteem. In different countries, health-care system regulations have fixed the threshold for reimbursement in 500 g of predicted tissue resection for each breast. Different preoperative measurements have been proposed to predict breast-tissue weight to be removed, showing a variable correlation with post-operative evaluation. We describe a reliable, simple measurement to predict the quantity of breast reduction in grams, which can be applicable to any surgical technique. A total of 128 patients undergoing bilateral breast reduction were evaluated. The correlation between the preoperative nipple-areola complex (NAC) lift distance and the weight of removed breast tissue was tested with linear regression and Pearson's test. Other anthropometric measurements were tested as a control. The ratio between resected grams and lift distance was explored to find a multiplication coefficient to be used at preoperative planning. The mean resection weight was 686.65 g. The mean NAC-lift distance was 7.6 cm. Positive correlation between the NAC-lift distance and the weight of breast tissue removed was found (r: 0.87; p < 0.001). The mean weight of the removed breast tissue (g) per centimetre of NAC lift was 81 g/cm in the group between 6 and 12 cm and 70 g/cm in the group with >12 cm of lift distance. The NAC-lift distance is a single, objective, repeatable measure that can provide a reliable prediction of breast-tissue grams to be removed; it helps in classifying breast-reduction indications.
authors.affiliation: Unit of Plastic, Reconstructive, Aesthetic Surgery, University of Naples "Federico II", Via Pansini 5, 80100 Naples, NA, Italy. Electronic address: marzia.moio@libero.it.
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Moio
authors.affiliation: Unit of Plastic, Reconstructive, Aesthetic Surgery, University of Naples "Federico II", Via Pansini 5, 80100 Naples, NA, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Schonauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D001940:Breast / Q000033:anatomy & histology* / Q000601:surgery; D005260:Female; D006801:Humans; D016014:Linear Models; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery*; D009929:Organ Size; D011300:Preoperative Care / Q000379:methods*; D055815:Young Adult
keywords: Breast reduction; Breast resection weight; Health-care system; Insurance coverage; NAC lift; Preoperative planning