caa a22 4500 463210271 CHVBK 20180405153138.0 cr unu---uuuuu 170326e20070501xx s 000 0 eng 10.1007/s00238-007-0117-y doi (NATIONALLICENCE)springer-10.1007/s00238-007-0117-y The spring-back phenomenon: does the final position of the nipple areola complex correspond to the pre-operative markings in reduction mammoplasty? [Elektronische Daten] [Yvette Godwin, Maria del Pilar Schneider] This study investigates whether tissue recoil or patient intrinsic factors influence the final position of the nipple areola complex (NAC) after reduction mammoplasty. The age, pre-operative ptosis, BMI and weight of the tissue resected were recorded as patient intrinsic factors in 37 patients undergoing reduction mammoplasty. The "spring-back” value was defined as the distance from the sternal notch to a nipple landmark on the breast meridian with the patient sitting up, minus the same measurement repeated with the patient recumbent to eliminate the pull of gravity on the breast. Spring back was measured pre-operatively for the nipple and nipple mark then post-operative for the nipple. The difference in centimeters between the final post-operative distance from the sternal notch to the nipple and the level intended by the pre-operative nipple mark was termed the "judgment error.” The final position of the post-operative nipple and the judgment error was compared to the spring-back values and patient intrinsic factors. Pre-operative ptosis was statistically related to increasing patient BMI and mass of tissue resected per breast. Pre-operative spring-back values for the nipple increased with increasing ptosis, BMI and decreasing age. Spring-back values were greater in the lower pole of the breast than in the upper pole. The final position of the nipple was higher than the pre-operative mark in 65% of cases, lower in 8% and as marked in 27% of cases. The post-operative NAC was, on average, 0.6cm higher than planned pre-operatively. The post-operative distance from the sternal notch to the nipple increased with increasing pre-operative ptosis, mass of breast tissue resected per breast and all three spring-back values. The difference between the level of the pre-operative mark and the final nipple position showed a weak correlation with post-operative spring-back values. The parameters of ptosis, BMI, weight of tissue resected per breast and pre-operative nipple spring back reflect body habitus and breast size. Spring-back values vary between the upper and lower pole of the breast. The final NAC position was higher than that intended at pre-operative marking in the majority of cases. The surgeon instinctively marks the nipple lower in patients with greater pre-operative ptosis and in whom a larger resection is anticipated. Judgment error did not relate to intrinsic factors nor to pre-operative spring-back values; hence, these parameters cannot be applied as predictive tools for more accurate pre-operative marking of the nipple position. This study suggests that the pre-operative nipple mark should be placed, with the patient sitting up, at least 23cm from the sternal notch and 0.6cm lower than the final position estimated using the inframammary crease as a landmark. Springer-Verlag, 2007 Pre-operative markings nationallicence Reduction mammoplasy nationallicence Godwin Yvette City Hospital Nottingham, Nottingham, UK aut del Pilar Schneider Maria Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, P.O. box 7023-S-75007, Uppsala, Sweden aut European Journal of Plastic Surgery Springer-Verlag 29/8(2007-05-01), 361-367 0930-343X 29:8<361 2007 29 238 https://doi.org/10.1007/s00238-007-0117-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00238-007-0117-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Godwin Yvette City Hospital Nottingham, Nottingham, UK aut NATIONALLICENCE 700 1- del Pilar Schneider Maria Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, P.O. box 7023-S-75007, Uppsala, Sweden aut NATIONALLICENCE 773 0- European Journal of Plastic Surgery Springer-Verlag 29/8(2007-05-01), 361-367 0930-343X 29:8<361 2007 29 238 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer