Regardless of the technique chosen, we feel it is extremely important to preserve all of the subcutaneous fat when dissecting the glandular tissue from the flaps. This ensures thick flaps that produce a pleasing contour and do not subsequently become tethered to the chest wall. For the same reason, we preserve the pectoralis fascia and definitely do not perform liposuction at the anterior aspect of the breast. However, the judicious use of liposuction can occasionally be indicated laterally or to attain better symmetry at the end of the procedure.
Measurements on the configuration of the nipple-areola complex revealed that 91 percent of the complexes were oval and only 7 percent were round.Describing the localization of the nipple-areola complex on the thorax by various measurements, the average distance from sternal notch to nipple was 20 cm. The average horizontal distance from the midsternal line to the nipple was 11 cm and the average distance from the sternal notch to the xiphoid was 20 cm. (photo scanned in from 2nd article below)Our results concerning the localization of the nipple with respect to the intercostal space showed that most of them were located in the fourth or the fifth intercostal space.Our findings in a European population showed a slightly smaller nipple-areola complex, with a mean diameter of 23 mm for round complexes and 27:20 mm for an oval complex.
The vertical excess of skin is determined by comparing the distance (“ground” distance, not “air” distance) from the inframammary crease to a horizontal line 4 inches below the middle of the clavicle. This measurement is made over the fullest portion of the breast, and it is compared with the corresponding vertical distance measured over the sternum. The difference between these measurements, added to the diameter of the areola, determines the vertical height of the larger (outside) “circle.”The horizontal excess of skin is determined by comparing the “ground” distance from the lateral border of the sternum to the anterior axillary line over the fullest portion of the breast with the corresponding horizontal distance at the level of the inframammary crease. The difference between these measurements, added to the diameter of the areola, equals the horizontal width of the larger (outside) “circle.”The smaller (inside) circle is the periphery of the areola. The larger “circle” is placed concentrically outside the areolar circle.