Vertical Scar Reduction Mammaplasty: The Fate of Nipple-Areola Complex Position and Inferior Pole Length

Abstract

A major advantage of vertical scar reduction mammaplasty is the improved long-term projection of the breasts. In their experience with more than 1700 cases, the authors have observed the following important trends: Postoperatively, the nipple-areola complex is located higher than one would predict from the preoperative skin markings, and pseudoptosis does not occur. This study was performed to provide objective measurements to confirm these observations. Forty-nine consecutive women had the following measurements taken of their right breast preoperatively and on postoperative day 5: distance from the clavicle to the superior border of the nipple-areola complex; the clavicle to the nipple; and the inframammary crease to the inferior border of the nipple-areola complex. Forty-six women were available for follow-up at 4 years, and measurements were repeated. Compared with preoperative skin markings, the nipple-areola complex was located on average 1.3 cm higher on postoperative day 5 and 1.0 cm higher at 4-year follow-up. The average distance from the inframammary crease to the inferior border of the nipple-areola complex had decreased 0.4 cm at 4-year follow-up. Compared with preoperative skin markings, the nipple-areola complex was located significantly higher at both early and long-term follow-up. The authors have adjusted their skin marking technique so that the superior border of the nipple-areola complex is marked at the level of the inframammary crease. At 4 years, the distance from the inframammary crease to the inferior border of the nipple-areola complex was significantly shorter, and pseudoptosis did not occur after vertical scar reduction mammaplasty.