The Sternum-Nipple Distance is Double the Nipple-Inframammary Fold Distance in Macromastia

Steele, Thomas N.; Pribaz, Julian J.; Lau, Frank H.

doi:10.1097/sap.0000000000001031

Cited by 6 publications

(15 citation statements)

References 25 publications

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“…21 A small selection of studies incorporated multiple pedicles. 17,19,21 The mean follow-up across all studies was 19.5 (±13.5) months. The focus of this study was on complication rates, with NAC necrosis as the primary factor.…”

Section: Resultsmentioning

confidence: 99%

“…The mean age and BMI of the study population was 39.2 ± 5.6 and 32.9 ± 3.4, respectively. Eleven studies 4,10–19 included smoking history as a comorbidity and found that 0% to 56.5% were active smokers or claimed a history of tobacco use 12,15 …”

Section: Resultsmentioning

confidence: 99%

“…The longest mean midclavicle-to-nipple distance was found to be 43.6 cm 13 . Six studies included the NAC-to-IMF distance with an average of 17.1 ± 1.7 cm 5,11,14,19,21,22 . The mean resection weight per breast was found to be 1423.8 g, with individual study means ranging from 1047.8 to 1946 g 23,24 …”

Section: Resultsmentioning

confidence: 99%

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Nipple-Sparing Gigantomastia Breast Reduction

et al. 2023

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Introduction There remains an unclear definition of the term “gigantomastia,” with many studies using different parameters and measurements. Currently, the operative management and patient education for gigantomastia are outdated. The historical teaching that a free nipple graft is necessary in elongated pedicles to avoid nipple necrosis may not be factual. The principal goal of our review aims to determine the safety of nipple-sparing breast reductions on large ptotic breasts via complication rate analysis. Methods The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines of conduct for systematic review and meta-analysis. In October 2021, PubMed was used to search the US National Library of Medicine database. Rayyan Intelligent Systematic Review aided in screening studies by title then abstract. If inclusion criteria were met, the entire article was reviewed. Results Twenty-two articles satisfied the inclusion and exclusion criteria. The study was composed of 1689 total patients with a mean body mass index of 32.9 (±3.4). Mean midclavicle-to-nipple distance and resection weight per breast was 39 cm (±3.8) and 1423.8 g (±268.9), respectively. A Wise pattern was preferred in 77.3% of the studies, with an inferior (45.5%) and superomedial (45.5%) pedicle used most commonly. Complete nipple areolar complex necrosis (1.7%) was found in 4 studies, whereas partial (5.9%) was observed in 11. More common complications included delayed wound healing (17.4%), surgical site infection (14.3%), seroma (10.5%), scar hypertrophy (9.9%), and wound dehiscence (9.2%). Conclusion Nipple-sparing breast reduction surgery can be safely performed on hypertrophic and severely ptotic breasts with nipple areolar complications, such as partial or complete nipple areolar complex loss, at a rate less than previously believed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Nipple-Sparing Gigantomastia Breast Reduction

et al. 2023

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“…This nipple displacement may be explained by changes in the ligamentous anatomy. 9,10 Matousek et al 9 reported that the breast is globally surrounded by taut ligaments. The medial breast ligaments are short and taut compared with the lateral ligaments, and hence, in some patients, as the breast enlarges, the nipple is displaced medially from the breast meridian.…”

Section: Discussionmentioning

confidence: 99%

Anthropometric Changes in a Prospective Study of 100 Patients Requesting Breast Reduction

Hudson

Lelala

2019

Plastic and Reconstructive Surgery - Global Open

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Background: The anthropomometry of the “ideal” breast is well described, but changes that occur with enlarged breasts are not. The aim of this study was to assess the prevalence of nipple asymmetry in the horizontal plane and changes in the inframammary fold (IMF) in patients presenting with macromastia (defined as excessive development of the mammary glands by Merriam-Webster dictionary). Methods: One hundred patients (200 breasts) presenting to the Plastic Surgery Clinic for bilateral breast reduction were enrolled in this study. Patients’ characteristics captured for this study included age, body mass index (BMI), and breast anthropometric measurements, such as suprasternal notch to nipple, nipple to IMF, IMF projected to cubital fossa, midhumeral point, and nipple measurement from meridian. Basic univariate statistical analyses were performed to evaluate the impact of nipple asymmetry. Results: The average age was 37 years (SD 12 years), and the median BMI was 33 (IQR 28–37). More patients presented with nipple asymmetry, of whom 45% were classified as lateral to the meridian, 19% were classified as medial to the meridian, and 36% were classified as central to the meridian. Patients with lateral asymmetry and medial asymmetry had a significantly higher BMI (median BMI 35) compared with patients with central positioning (median BMI 30). Increasing breast size was positively associated with nipple asymmetry, whereas BMI ( R = −0.30, P = 0.003) and macromastia correlated negatively with IMF position ( R = −0.38, P = 0.0001). Conclusion: In macromastia, nipple displacement from the breast meridian, especially lateral displacement, is common and is aggravated by an increase in BMI. The IMF also descends, and this is also more common in patients with a raised BMI. These changes have clinical implications.

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“…Steele et al 3 studied the comparative strength of the upper and lower breast pole suspensory ligaments with proxies for upper and lower suspensory ligament strength and found that sternal notch-to-nipple distance was double Once duplicates from different databases were removed, 39 articles remained. Of these, 19 articles were excluded from the review.…”

Section: Intraglandular Fascia and Ligaments Cooper Ligamentsmentioning

confidence: 99%

Anatomy of the Breast Fascial System: A Systematic Review of the Literature

Duncan

Youha

Joukhadar

et al. 2021

Plastic &Amp; Reconstructive Surgery

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Background: Understanding the anatomy of the fascial and ligamentous structures of the breast is important in both aesthetic and reconstructive breast surgery. Several structures have been identified that play a significant role in the aesthetic qualities and support of the breast warranting consideration in the context of breast reconstruction. Methods: The authors performed a systematic review of anatomical, clinical, histologic, and radiologic studies that have described, characterized, and named these structures. The authors have summarized and critically appraised prior research to clarify and define the key fascial structures of the breast, their anatomical function, and their clinical significance in aesthetic and reconstructive breast surgery. Results: Through their review, six distinct breast fascial structures were encountered consistently in the literature. The authors have organized them into intraglandular and extraglandular structures and have reviewed their significance in the context of reconstructive breast surgery. Conclusions: The primary fascial structures of the breast are important anatomical landmarks with numerous clinical applications. Cooper ligaments divide the breast parenchyma. The superficial and deep layers of the superficial fascia encase the breast in a "pocket," condensing into one thickened layer of fascia along the peripheral breast footprint. The inframammary fold supports and defines the inferior pole. The horizontal septum is a reliable neurovascular landmark. The vertical septum is a newly discovered fascial structure. There are certainly clinical implications that have yet to be described because of the relatively limited and disputed information on the fascia of the female breast and, ultimately, more research is warranted.

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The Sternum-Nipple Distance is Double the Nipple-Inframammary Fold Distance in Macromastia

Cited by 6 publications

References 25 publications

Nipple-Sparing Gigantomastia Breast Reduction

Nipple-Sparing Gigantomastia Breast Reduction

Anthropometric Changes in a Prospective Study of 100 Patients Requesting Breast Reduction

Anatomy of the Breast Fascial System: A Systematic Review of the Literature

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