Objective evaluation of nipple position after 336 breast reductions

Throughout different eras and cultures what is considered the cosmetically ideal breast has varied greatly. There is no broadly accepted standardised method that objectively evaluates aesthetic outcome after breast reduction mammoplasty. The primary aim of this study was to evaluate the result of breast reduction regarding nipple position, comparing it to an objective previously described standard. Secondary aims were to determine symmetry and examine predictors for achieving an aesthetically pleasing breast. The position of the nipple was measured in postoperative pictures and compared to a previously described standard. Three-hundred and thirty-six breast were included in the study. Compared with the previously described standard, 26% (89/336) of the nipples were within the optimal position in mediolateral direction, and 44% (147/336) in craniocaudal direction. The majority of women had the nipple in the same position in the two breasts. Age at surgery seems to significantly influence the possibility of achieving an optimal nipple position. No other predictors were found. Improvements can be made in placement of the nipple during reduction mammoplasty. Further studies are needed on how knowledge of the ideal nipple position can be used to optimize surgical planning and technique, and reduce variability in outcomes, in breast reduction mammoplasties.