Hyun Ho Han1, Kenneth K Kim, Kee Hoon Lee, DaEun Park, Jong Won Rhie, Sang Tae Ahn, Paik Kwon Lee. 1. Seoul, Republic of Korea; and Los Angeles, Calif. From the Department of Plastic Surgery, College of Medicine, The Catholic University of Korea, and the Apgugeong Avenue Plastic Surgery Clinic; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.
Abstract
BACKGROUND: Optimal augmentation mammaplasty results not only from proper implant size and breast shape, but also from the minimization of postoperative scarring, especially in patients prone to hypertrophic scars. In this context, the authors present a transareolar-perinipple (areolar omega) zigzag approach. METHODS: Between March of 2003 and June of 2012, a total of 613 patients underwent augmentation mammaplasty using a transareolar-perinipple incision. Among them, 45 patients received a classic (straight line) transareolar-perinipple incision, whereas 568 patients received a modified zigzag transareolar-perinipple incision. RESULTS: Patients' ages ranged from 21 to 60 years. Areola size varied from 2.3 to 4.5 cm in diameter. Follow-up duration ranged from 1 to 10 years, with an average of 2 years 7 months. Postoperative complications included capsular contracture, which occurred in 16 patients (2.6 percent). Nine patients (1.5 percent) had Baker class II and seven patients (1.1 percent) had Baker class III capsular contracture. Mild inferior displacement of the implant occurred in four patients (0.6 percent). The prevalence of areolar distortion was 3.4 percent. Nipple hypesthesia was found in approximately 70 percent of the patients, which returned to normal after 2 to 3 months. Based on third-party observers, 74.7 percent of patients who received zigzag transareolar-perinipple incision had excellent to good scarring results. CONCLUSIONS: The transareolar-perinipple (areolar omega) zigzag incision resulted in satisfactory postoperative scarring and surgical results in Asian patients. This method increases the opening of the areolar incision and can be performed in patients with small (<3.5 cm) areolas. This approach can be an alternative in patients who are prone to hypertrophic scarring. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
BACKGROUND: Optimal augmentation mammaplasty results not only from proper implant size and breast shape, but also from the minimization of postoperative scarring, especially in patients prone to hypertrophic scars. In this context, the authors present a transareolar-perinipple (areolar omega) zigzag approach. METHODS: Between March of 2003 and June of 2012, a total of 613 patients underwent augmentation mammaplasty using a transareolar-perinipple incision. Among them, 45 patients received a classic (straight line) transareolar-perinipple incision, whereas 568 patients received a modified zigzag transareolar-perinipple incision. RESULTS:Patients' ages ranged from 21 to 60 years. Areola size varied from 2.3 to 4.5 cm in diameter. Follow-up duration ranged from 1 to 10 years, with an average of 2 years 7 months. Postoperative complications included capsular contracture, which occurred in 16 patients (2.6 percent). Nine patients (1.5 percent) had Baker class II and seven patients (1.1 percent) had Baker class III capsular contracture. Mild inferior displacement of the implant occurred in four patients (0.6 percent). The prevalence of areolar distortion was 3.4 percent. Nipple hypesthesia was found in approximately 70 percent of the patients, which returned to normal after 2 to 3 months. Based on third-party observers, 74.7 percent of patients who received zigzag transareolar-perinipple incision had excellent to good scarring results. CONCLUSIONS: The transareolar-perinipple (areolar omega) zigzag incision resulted in satisfactory postoperative scarring and surgical results in Asian patients. This method increases the opening of the areolar incision and can be performed in patients with small (<3.5 cm) areolas. This approach can be an alternative in patients who are prone to hypertrophic scarring. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.