Medical Leeches for the Salvage of a Nipple Areola Complex

Abstract

Introduction: A breast lift combined with the insertion of breast implants is a popular surgery in the United States. The volume added by the implant increases the pressure and tension on the breast tissues. Difficulties with venous drainage of the transposed nipple areola complex (NAC) can result in the catastrophic partial or total necrosis of these structures. Draining or removing the stagnating blood from the capillary system will improve the microcirculation and avoid further complications (ie, NAC necrosis). Materials and Methods: A breast lift/reduction with concomitant insertion of breast implants in a 39-year-old female was performed without intraoperative complications. The patient was seen for follow-up the next morning. The left breast NAC showed a remarkable bluish discoloration. The diagnosis of venous congestion was obvious. Medicinal leeches were applied to the left NAC. Treatment with the leeches was repeated every 12 hours for 2 days. Results: The areola became pink and matched the color of the unaffected side. There was no tissue necrosis and healing was exactly the same as for the right breast. No treatment complications developed. Conclusions: NAC necrosis is not uncommon after breast surgery. This problem is undoubtedly a compromise of the venous return. If any doubt arises after this surgery, leech therapy should be performed to decrease the chances of this catastrophic complication.