Clinical Research, For After Breast Augmentation Surface Signs Change And Its Influencing Factors

Objective:The goal of this study was to analyze the law of position change of body surface landmarks after augmentation mammaplasty,identify the key parameters for preoperative planning,determine the optimal relative position between nipple and infra-mammary fold(IMF),establish a method for locating the ideal postoperative position of infra-mammary fold.Method:Measurements of body surface landmarks and dimensions of the implants from 30 augmentation cases,which were rated satisfactory simultaneously by patient,surgeon and third party,were documented before and at least 1 month after operation.These data were analyzed statistically to determine the relationship among changes of pre- and postoperative measurements of body surface landmarks,dimensions of implants and pre-operative measurements of body surface landmarks.Changes of position of nipple and IMF were specially studied to determine the ideal relative position of post-operative nipple,IMF and implant.Results:1 After operation,the nipple shifted superiorly and laterally for 1.04±0.63cm and 1.12±0.47cm,respectively.The IMF level shifted inferiorly for 1.20±1.03cm.The width of the breast base increased 1.39±1.26cm.Surface distance from nipple to IMF increased 1.87±0.85cm.2) The postoperative variation of nipple shifting up correlated to the projection of implants(correlation coefficient was 0.30,p=0.02) and pre-operative breast(correlation coefficient was 0.31,p=0.04) instead of the plane of implants pocket.The equation for nipple shifting up was "dS -Np=3.83-0.62×IMPp-0.035×dCC".3) Postoperative variation of IMF shifting inferiorly correlated to implant height(correlation coefficient was 0.36,p=0.00),instead of the surface distance from nipple to IMF or the difference of chest circumference.4) The distance from nipple to ideal IMF level plane could be located by this equation:0.52×IMPh+0.62×IMPp+ 0.035×dCC-2.80.Conclusion:1) The position of nipple and IMF could be precisely described by distance from jugular notch to nipple level plane and IMF level plane. Combined with surface distance from nipple to IMF(N-IMF),base width(BW), distance from nipple to sternal line(N-SL) and difference of chest circumference(dCC),the change of breast contour could be imaged.These are basic key parameters in preoperative planning and postoperative evaluation.2) The main influencing factors on postoperative shifting superiorly of nipple were implant projection and preoperative breast projection.3) Implant height was key factor to determine postoperative distance between nipple and infra-mammary fold level plane.4) The equation, 0.52×IMPh+0.62×IMPp+0.035×dCC-2.80,could help locating ideal postoperative infra-mammary fold.