Total Nipple-Areola Complex Necrosis in Inferior Pedicle Breast Reduction

Calderón, Wilfredo; Eulufi, Alex; Borel, Claudio; Léniz, Patricio; Calderon, Daniel

doi:10.1097/01.prs.0000222228.81754.26

Cited by 8 publications

(3 citation statements)

References 5 publications

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“…The risk of partial or total loss of the NAC is~1% depending on the degree of ptosis, breast size, volume of tissue resection, and patient factors such as smoking, obesity, diabetes, and hypertension etc. (2,3).…”

Section: Late Nipple Necrosis After Breast Reduction and Microvasculamentioning

confidence: 99%

Late Nipple Necrosis after Breast Reduction and Microvascular Angina in Same Patient: Is There a Link?

Yunaev

Martin

2014

Breast J

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Section: Late Nipple Necrosis After Breast Reduction and Microvasculamentioning

confidence: 99%

Late Nipple Necrosis after Breast Reduction and Microvascular Angina in Same Patient: Is There a Link?

Yunaev

Martin

2014

Breast J

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“…The important factor in deciding whether to continue to perform using the inferior pedicle technique or switch to the free nipple technique is the viability of the pedicle (11,12) because an ischemic pedicle leads to necrosis of the NAC. To avoid this disastrous complication (13,14), perioperative conversion to free nipple graft is a good and safe option if the pedicle viability is grossly compromised in the inferior pedicle technique.…”

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confidence: 99%

Pedicle Viability As the Determinant Factor for Conversion to Free Nipple Graft

Cabs

2010

Canadian Journal of Plastic Surgery

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INTRODUCTION Women with extremely large breasts have many complaints. Reduction mammaplasty improves shape and relieves physical symptoms and alleviates psychological complaints. Mammaplasty is a an evolving technique; no single method is ideal or suitable for all breasts. Many techniques are advocated for reduction mammaplasty, including the superior, vertical, horizontal, lateral and inferior (the most popular) pedicle techniques. Even after 60 years of development in breast reduction techniques, there are still reported incidences of nipple-areola complex (NAC) necrosis. Objective To assess the perioperative conversion to free nipple graft to prevent the complication of nipple necrosis when pedicle viability is grossly compromised. Methods Between January 2002 and March 2006, 66 patients (132 breasts) underwent reduction mammaplasty using the inferior pedicle technique. The patients presented with breast gigantism and required excision of more than 1000 g of breast tissue per side. The mean patient age was 34.81 years. Patients had neck, shoulder and back pain as well as psychological complaints. Data regarding sternal notch-to-nipple distances and inframammary fold-to-nipple distances were recorded preoperatively and postoperatively. The weights of the excised breast tissue from either side were recorded. Viability of the pedicle flap was carefully monitored through perioperative clinical observation of skin colour, temperature, capillary refill and bleeding characteristics, and reassessed after pedicle folding and placement inside the newly tailored skin envelope. Nonvital NAC, as evaluated by the surgeon during surgery, necessitated conversion to the free nipple graft technique. Results During the course of the study, two patients (four breasts; 3.03%) exhibited impending gangrene to the NAC, and perioperative conversion to the free nipple graft was performed. In these two patients, the pedicle length ranged from 23 cm to 25 cm, and breast mass reduction ranged from 1950 g to 2250 g. Conclusion Perioperative conversion to a free nipple-areola graft is always a good and safe option when impending gangrene to the NAC is evident during mammaplasty by inferior pedicle technique.

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“…To avoid this disastrous complication (13,14), perioperative conversion to free nipple graft is a good and safe option if the pedicle viability is grossly compromised in the inferior pedicle technique.…”

Section: Introductionmentioning

confidence: 99%

Pedicle viability as the determinant factor for conversion to free nipple graft

Al-shaham¹

2010

CAN J PLAST SURG

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Total Nipple-Areola Complex Necrosis in Inferior Pedicle Breast Reduction

Cited by 8 publications

References 5 publications

Late Nipple Necrosis after Breast Reduction and Microvascular Angina in Same Patient: Is There a Link?

Late Nipple Necrosis after Breast Reduction and Microvascular Angina in Same Patient: Is There a Link?

Pedicle Viability As the Determinant Factor for Conversion to Free Nipple Graft

Pedicle viability as the determinant factor for conversion to free nipple graft

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