4960 A New Technique for Repositioning of the Nipple In Aesthetic Breast Surgery

Friday, May 6, 2011
H. Eray Copcu, Associate, Professor1, Nazan Sivrioglu2 and Saime Irkoren2, (1)Aesthetic, Plastic and Reconstrutive Surgery Department, Adnan Menderes University, Medical Faculty, Aydin, Turkey, (2)Aesthetic, Plastic and Reconstructive Surgery Department, Adnan Menderes University, Medical Faculty, Aydin, Turkey
Goals/Purpose: Many factors affect the final results in aesthetic breast surgery.  Multiple maneuvers were described in the literature for the reshaping of the breast and nipple repositioning. In this study, we use suture plication for the lifting of the nipple in breast reduction or mastopexy, or lowering of the nipple in high located nipples as a complication of the previous breast surgery.

Methods/Technique: In mastopexy and breast reduction surgery, plication is made in such a way to create a cone at the two o’clock and ten o’clock positions of the NAC with oblique continuous suture with 2/0 PDS. This plication is not dermal suspension. Areolar tissue, fat tissue and glandular tissue of breast are plicated. The suture technique used in our mammaplasty is similar to that described by Tonnard for MACSlift. Also, we use reverse plication for the correction of the high located nipples after breast reduction surgery.  Lowering of the nipple was performed with same suture material at four o’clock and eight o’clock positions of the nipple.

Results/Complications: Conical plication was used in breast reduction surgery in 64 patients, and in mastopexy in 21 patients as a part of COPCU’s (COnical Plicated Central U shaped) Mammaplasty Technique. Also 4 patients were operated with reverse conical plication for the correction of high located nipple. Pre and post operative measurements were compared and adequate lifting and lowering were provided with this technique in all patients.  Since we performed conical plication we would like to evaluate long term effects of the plication in the breast parenchyma. Breast parenchyma was visualized with USG in younger patients and mammography in older patient in postoperative 6 months and 1 year. We never observed any problem related with our sutures.

Conclusion: Conical plication and reverse plication are the reliable, successful and easy techniques for the repositioning of the nipple in breast surgery.

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