Sensitivity of the Nipple-Areola Complex in Reduction Mammaplasty Following Periareolar Dermis Section.

BACKGROUND: Preservation of the periareolar dermis, after de-epithelization in reduction mammaplasty, may result in reduced nipple-areola complex (NAC) mobility. Consequently, distortion in shape and difficulty correcting the areola position can occur. OBJECTIVES: The aim of this study was to evaluate NAC viability and sensitivity resulting from periareolar dermis section after de-epithelization in patients who underwent reduction mammaplasty surgery. METHODS: This study was a randomized, controlled double-blind clinical trial. A total of 41 patients (82 breasts) were randomly allocated into 2 groups and underwent reduction mammaplasty-involving the superior pedicle-with a final inverted T-shaped scar. A sectioning of the periareolar dermis was performed on the breasts in the experimental group. Semmes-Weinstein monofilaments were used to evaluate NAC sensitivity at the preoperative evaluation, and 3, 6, and 52 weeks after surgery. RESULTS: No cases of partial or total NAC necrosis were noted in either group. The comparison between the groups did not show significant differences regarding NAC sensitivity. However, a statistically significant difference was noted when sensitivity levels at the preoperative evaluation and 3 weeks after surgery were compared in the experimental group. A significant difference was noted when the scores of the sensitivity 3 weeks after surgery were compared between the control and the experiment groups. Nevertheless, after 1 year, no statistical differences were observed in the experimental group or between both groups. CONCLUSIONS: The sectioning of the periareolar dermis does not affect the viability or the pressure sensitivity of the NAC.

Avaliação da sensibilidade do complexo areolopapilar após mamoplastia redutora com liberação dérmica versus volume ressecado de tecido mamário / Evaluation of the nipple­areola complex after reduction mammoplasty with dermal release versus resected volume of the breast tissue

Introdução: O complexo areolopapilar (CAP) desempenha grande importância tanto na amamentação quanto na vida sexual das pacientes, consequentemente, devemos ressaltar que uma complicação potencial da mamoplastia redutora é a alteração ou até a perda da sensibilidade do CAP. Método: Estudo prospectivo, randomizado, controlado e duplo-cego para avaliar a relação entre a sensibilidade do complexo areolopapilar após mamoplastia redutora com liberação dérmica e o volume ressecado de tecido mamário. O estudo ocorreu no período de agosto de 2013 a agosto de 2015, no Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE). Resultados: O estudo totalizou 39 pacientes. A média de idade da amostra foi de 31,7 anos, índice de massa corporal (IMC) médio de kg/m2 e nenhuma das pacientes era tabagista. A taxa de comorbidade foi de 5,1% da amostra. O índice de complicações foi de 41%, composto de 7 casos de cicatriz inestética, 6 de hematoma e 4 de deiscência. Não houve caso de sofrimento ou necrose do CAP e todas as pacientes se mostraram satisfeitas com o resultado cirúrgico final. Não houve diferenças estatisticamente significantes em nenhuma das ocasiões entre os pacientes do grupo experimento e controle, tanto no grupo de ressecção de até 300 gramas quanto acima de 300gramas. Conclusões: A manobra de liberação dérmica não provocou diferença na sensibilidade do complexo areolopapilar, independentemente da quantidade de tecido mamário ressecado.

Introduction: The nipple­areola complex (NAC) plays an important role both in breastfeeding and sexual lives of the patients. Because of this, we must mention possible complications of reduction mammoplasty, such change or even loss of sensitivity of the NAC. Method: This was a prospective, randomized, controlled, double-blind study to evaluate the relationship between the sensitivity of the NAC after reduction mammoplasty with dermal release and the resected volume of breast tissue. This study was conducted between August 2013 and August 2015 at the Hospital das Clínicas of the Federal University of Pernambuco (HC-UFPE), in Recife City, Brazil. Results: The study involved 39 patients. The mean age and body mass index (BMI) of the patients were 31.7 years and 25.5 kg/m2, respectively. None of the patients was a smoker. The complication rate was 41%, including 7 cases of non-aesthetic scars, 6 cases of hematoma (bruises), and 4 cases of dehiscence. No patient had pain or NAC necrosis, and all the patients expressed being satisfied with the final surgical result. No statistically significant differences were found between the patients of the experimental and control groups, both in the group with resection of up to 300 g and those with resection >300 g. Conclusions: The maneuver of dermic release did not result in any differences in the sensitivity of the NAC, regardless of the quantity of resected breast tissue.