Comparison of incisions between two approaches in areolar reduction surgery

Objective To compare the perinipple round-block technique with the conventional periareolar round-block technique in areolar reduction operations.Methods A total of 37 patients who underwent areolar reduction operations in our department were randomly allocated into two groups:Group A (19 patients) received a conventional periareolar round-block technique,while group B (18 patients) through a new perinipple round-block technique.In the latter approach,an intraareolar donut of pigmented skin was deepithelialized,and the exposed areolar dermis was then telescoped inward and stretch-anchored to an imaginary circular line situated beneath the breast skin areola junction.The roundblock technique was then utilized to approximate the skin edges,resulting in a minimal scar,totally inconspicuous,confined to the immediate perinipple area.The operative time,perioperative complications,scars,absorption time of the skin folds,the sensation of the nipple-areolar complex and the patients' satisfaction were compared between the two groups.Results The mean operative time of group A and group B was 40.5 min and 45.8 min,respectively (P＜0.05).No perioperative complications were found in these two groups.No patient had experienced permanent nipple sensory changes.The skin folds absorption time of group A was 4.34 months,while the time of group B was 8.78 months (P＜0.01).The perinipple round-block technique produced a more inconspicuous scar with a better aesthetic results.Conclusions The traditional periareolar round-block technique leaves a sharply demarcated areola by a circular scar which has a totally unnatural and artificial look.As for the perinipple round-block technique,the incision as well as any residual cutaneous wrinkling or puckering is well concealed by the dome of the nipple and the areolar,but it needs a longer skin folds absorption time. Key words: Mammoplasty;  Areola;  Nipples;  Cicatrix