Vertical and Horizontal Coordinates of the Nipple-Areola Complex Position in Males

Abstract

After massive weight loss, male breasts in particular are one of the most disturbing body regions and can be a difficult area to treat often requiring nipple-areola repositioning. The need for bilateral repositioning of the nipple-areola complex is also increasing in other surgical fields such as in female-to-male transsexual patients with large breasts and in patients with severe forms of gynecomastia. Proper configuration and localization of the nipple-areola complex requires both meticulous planning and a thorough understanding of the male anatomy and is essential in determining final aesthetic outcome. Currently available guidelines create areolas that are too large, place the nipple-areola complex too high and too far medially, and/or require complex abstract mathematical calculations. Relying on the recently appreciated aesthetic value of the golden number Phi (phi) we propose an easy and reliable method to determine the horizontal and vertical coordinates of the male nipples. With only 2 easily measurable distances, umbilicus-anterior axillary fold apex and umbilicus-suprasternal notch, the internipple distance and the position of the horizontal nipple plane relative to the suprasternal notch can be calculated. The internipple distance can be determined with 95% accuracy and the distance from the suprasternal notch can be determined in 80% of cases within a range of 3.33 +/- 1.25 cm.

Crowdsourcing the Ideal Nipple-Areolar Complex Position for Chest Masculinization Surgery

“…Also, the parameters of Image B may be less practical in an operating room setting, due to its use of mathematical formulas for NAC localization. 25 …”

“…This was calculated from the equations (N-N) = (0.618 × U-AX) and (suprasternal notch to horizontal nipple plane) = (U-AX)/2, where U-AX is the umbilicus to axillary fold distance. 25 U-AX distance was determined to be 31.5 cm, using the measuring tool in the Adobe software and the assumed average female height of 5′4″. For Image C, the NACs are located 21 cm from each other.…”

Augmentation Mastopexy: Implementing Autologous Breast Tissue for Optimum Results; Case Series Study with a Nine-Month Follow-up

“…The position of NAC is very important to obtain satisfactory results. Atiyeh et al, [22] and Gusenoff and Co-workers [4] studied this issue in detail. In our technique, we tried to simplify this issue to add more facility to the technique.…”

Operatives Management und Techniken der Mastektomie bei Frau-zu-Mann Transsexuellen

“…Bez ü glich der Positionierung der Mamille nach Mastektomie mittels Submammarschnitt fi nden sich in der Literatur Formeln zur Lageberechunung, wesentliche Parameter sind dabei die Patientengr ö ß e, der Thoraxumpfang und der Jugulum-Mamillenabstand sowie die Distanz zwischen Bauchnabel und vorderer Axillarlinie bzw. Bauchnabel und Jugulum [2,8,9,12,14] . Nach unserer Auff assung ist ä hnlich wie bei anderen Autoren die klinische Einsch ä tzung der Mamillenlage ausschlaggebend [6,11] , wir orientieren uns hier v. a. an der unteren Pectoraliskante sowie an der Medioclavicularlinie [11] und setzen zur Beurteilung den Patienten intraoperativ auf [6] .…”