LAUSR

BACKGROUND There is some controversy regarding whether the nipple-areola complex (NAC) is elevated, remains stable or is lowered in breast augmentation. There is a general belief that one can modulate its position depending on the implant chosen. In addition, many preoperative markings include elevating the arms to predict the final position of the NAC. OBJECTIVES To study the changes in the position of the NAC and determine whether the postoperative position of the NAC can be predicted preoperatively by elevating the arms. METHODS The authors included 45 patients. A three-dimensional (3D) scan was used to take basal (preop) and 12-month measurements with the patient's arms in abduction and elevated over the head. The distances measured were the sternal notch-nipple (SN-Ni), nipple-nipple (Ni-Ni) and nipple-inframammary fold (Ni-IMF) distances. RESULTS With arms abducted, the SN-Ni distance increased by 6% when measured linearly, 8.5% when measured on the skin surface and 1% to 2% when measured on the sternal line. The Ni-ni distance increased by 9% (linear) and 15% (over the surface). The Ni-IMF increased by 44%. With the arms adducted, the SN-Ni distance increased by 9% (linear), 12% (on the skin surface) and 0.5% at the sternal midline projection. The Ni-n distance increased 11% (linear) and 19% (on the surface). The Ni-IMF distance increased by 53%. The postoperative position of the NAC with the arms abducted increased by 17% compared to the preoperative position in adduction. CONCLUSIONS Implants do not elevate the NAC; its position remains nearly unaltered. The Sn-n distance was increased in 90% of the patients. Lifting the arms for preoperative markings does not help to predict the postoperative position of the NAC.