Evaluation of Sensitivity in Specific Points of the Areola and Nipple of Patients Submitted to Reduction Mammoplasty With Periareolar Dermis Release: A Randomized Controlled Study.

BACKGROUND: To date, studies on periareolar dermis release have recorded the areola sensitivity as a mean. Despite being clinically reported by patients, specific points of the areola may present sensitivities not detected when researchers only consider mean values. OBJECTIVES: The aim of this study was to determine the pressure sensitivity at specific points of the nipple-areola complex and compare these values with the mean value measured in the areolas of patients undergoing reduction mammaplasty with periareolar dermis release. METHODS: This is a prospective, randomized controlled trial of 39 consecutive patients (78 breasts) who underwent surgery for treatment of breast hypertrophy; the same surgical technique was used for all patients. In each patient, 1 breast was assigned to a control group and the other to an experimental group. The periareolar dermis release was performed in the experimental group (39 breasts). Pressure sensitivity was tested with Semmes-Weinstein monofilaments on the papilla and at 4 specific points of the areola. The evaluations were conducted preoperatively and at 3 weeks, 6 weeks, and 1 year postoperatively. RESULTS: The group comparisons show a statistically significant difference in sensitivity at the medial point of the areola and in the papilla at 3 weeks postoperation. This difference disappeared in the 1-year evaluation. This recovery profile also occurs when areola sensitivity corresponds to a mean value. The sensitivity significantly decreased at the lower point of the areola up to 1 year postoperation in the control and experimental groups. CONCLUSIONS: The periareolar dermis release did not compromise the pressure sensitivity at the points evaluated in the nipple-areola complex. The mean areola sensitivity differed from the sensitivity at the lower point of the areola.

Evaluation of the Sensitivity of the Nipple-Areola Complex in Patients Undergoing Breast Ptosis Correction with Periareolar Dermis Release: A Randomized Controlled Trial.

BACKGROUND: In the surgical treatment of breast ptosis, the plastic surgeon's main challenge is to mobilize the nipple-areola complex (NAC) over long distances, preserving its sensitivity. Herein, we aimed to evaluate the NAC sensitivity following a periareolar dermis release in patients undergoing surgical correction of breast ptosis. METHODS: This is a prospective, double-blinded, randomized study in which 39 patients (78 breasts) were operated on for the treatment of breast ptosis. Patients' breasts were divided into two groups, each breast in a group. In breasts of the experiment group, the periareolar dermis release was used after decortication. This maneuver was not used in the control group's breasts. To analyze the sensitivity in relation with the distance that the NAC should be mobilized to correct breast ptosis, the value of 6 cm was used as boundary. Sensitivity of the NAC was assessed with monofilaments preoperatively and postoperatively-at three and six weeks and one year. RESULTS: Regarding the sensitivity of the areola, a significant difference was observed in the comparison between the control and experiment groups at the NAC mobility ≤ 6.0 cm in the preoperative. Regarding the nipple, a significant difference was observed in the comparison between the control and experiment groups at three weeks postoperatively for a NAC mobility ≤ 6.0 cm. After one year, there was no difference in the comparison between the groups in either areola or nipple. CONCLUSION: The periareolar dermis release does not compromise NAC vascularization and pressure sensitivity in patients undergoing breast ptosis correction. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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.