Nipple-areola complex sensitivity after primary breast augmentation: a comparison of periareolar and inframammary incision approaches.

BACKGROUND: The body of literature documenting normative breast sensation and postoperative changes in sensation after reduction mammaplasty has grown considerably over the last several years. Despite this, only two studies have ever been published on the subject of postaugmentation mammaplasty sensory outcomes. The purpose of this study was to precisely measure sensory thresholds at the nipple-areola complex in women who have undergone augmentation mammaplasty by either the inframammary or periareolar approach. METHODS: Twenty women underwent primary augmentation mammaplasty by either the periareolar or inframammary approach at an average follow-up of 1.12 years. Sensory testing was performed using the Pressure-Specified Sensory Device by comparing moving and static sensory thresholds at the upper and lower areola and nipple. Nine women served as size-matched, nonoperated controls in the study. RESULTS: Primary augmentation mammaplasty was found to have a statistically significant negative effect on sensory outcomes when nonoperated controls were compared with women who had undergone augmentation mammaplasty via either the periareolar or inframammary approach. No differences in sensory outcomes were found between the two approaches used. Implant volume was found to be highly predictive of sensory outcomes, with an inverse relationship between implant size and the degree of sensitivity within the nipple-areola complex. CONCLUSIONS: Plastic surgeons should feel comfortable counseling patients that augmentation mammaplasty by either the inframammary or periareolar approach results in no discernible differences in sensory outcomes. Furthermore, women who choose very large implants relative to their breast skin envelopes should be warned about potential adverse sensory sequelae within the nipple-areola complex.

Beauty lies in the "eyebrow" of the beholder: a public survey of eyebrow aesthetics.

BACKGROUND: Several studies have attempted to define the dimensions of an aesthetically pleasing eyebrow. However, these dimensions represent the views of plastic surgeons and cosmetologists, not necessarily the general public. We hypothesized that many patients who present to their plastic surgeon for periorbital rejuvenation actually want their eyebrows to be in a more natural position than was represented in the studies we surveyed. OBJECTIVE: A study was designed to define the dimensions of an aesthetically pleasing eyebrow from the perspective of the general public. This was achieved by surveying individuals in our local community. METHODS: One hundred individuals were surveyed and asked to rank 27 photographs (including photographs of pre- and postoperative patients and of models) on a scale of 1 to 10 and grade each photograph as either "attractive" or "unattractive". Each survey taker provided extensive background information. The photographs receiving the highest number of points and "attractive" grades were then analyzed for eyebrow dimensions. The following distances were measured: medial canthus (MC) to medial eyebrow (ME), lateral limbus (LL) to lateral eyebrow (LE), and eyebrow arch position (EAP) to eye width (EW). Ratios were determined using the EW for comparison. We also evaluated the EAP in relation to the LL. RESULTS: The eyebrow dimensions (mean +/- SD) of the most highly ranked female photographs were as follows: MC-ME:EW ratio 0.573 +/- 0.126, LL-LE:EW ratio 0.668 +/- 0.083, and EAP:EW 0.703 +/- 0.1. The eyebrow dimensions (mean +/- SD) of the most highly ranked male photographs were as follows: MC-ME:EW ratio 0.547 +/- 0.177, LL-LE:EW ratio 0.58 +/- 0.171, and EAP:EW 0.63 +/- 0.175. The EAP in relation to the LL was found to be 0.925 +/- 0.884 cm lateral to the LL in women, and 1.05 +/- 1.04 cm lateral to the LL in men. CONCLUSIONS: Previously published dimensions of an aesthetically pleasing eyebrow, as defined by plastic surgeons and cosmetologists, differ from dimensions currently defined as attractive by the general public in our study.