Skip to main content
Top
Published in: Aesthetic Plastic Surgery 2/2015

01-04-2015 | Original Article

Anatomy of the Superficial Layer of Superficial Fascia Around the Nipple-Areola Complex

Authors: Takako Komiya, Norihito Ito, Ryutaro Imai, Masahiro Itoh, Munekazu Naito, Jun Matsubayashi, Hajime Matsumura

Published in: Aesthetic Plastic Surgery | Issue 2/2015

Login to get access

Abstract

Background

The periareolar incision is the preferred method for mammaplasty because of the minimal scarring, and suturing of the superficial fascial system (SFS) is useful for avoiding hypertrophic scarring. In this report, we describe the anatomical location of the SFS around the nipple-areolar complex (NAC) and its histological structure.

Methods

To define the location of the SFS, 20 healthy women were assessed by ultrasonography, and sections of the NAC of 10 female cadavers were examined under a light microscope.

Results

Ultrasonographic examination of sagittal sections of the breast revealed a hyperdense line immediately beneath the skin, which ran parallel with the skin and turned under the NAC. At the turning point, the line thickened to an average of 3.09 mm. The distance between the nipple and the thickest point of the hyperdense line was 10.14 mm on average. Histological structures of the line were collagen and elastic fibers containing smooth muscles that were connected to the dermis and adipose tissue. At the turning point, nerves, blood vessels, and mammary ducts were irregularly observed in the area of collagen and elastic fibers. These structures were intermingled, and the fiber bundle was very thick.

Conclusions

The thickest area of the turning point is an area of the superficial layer of superficial fascia, which is a key structure around the NAC. The detailed anatomical data shown in our study provide good morphological landmarks for the closure of periareolar incisions.

No Level Assigned

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://​www.​springer.​com/​00266
Literature
1.
go back to reference Gonzalez R (2012) The PAM method–periareolar augmentation mastopexy: a personal approach to treat hypoplastic breast with moderate ptosis. Aesthet Surg J 32:175–185CrossRefPubMed Gonzalez R (2012) The PAM method–periareolar augmentation mastopexy: a personal approach to treat hypoplastic breast with moderate ptosis. Aesthet Surg J 32:175–185CrossRefPubMed
2.
go back to reference Lockwood T (1999) Reduction mammaplasty and mastopexy with superficial fascial system suspension. Plast Reconstr Surg 103:1411–1420CrossRefPubMed Lockwood T (1999) Reduction mammaplasty and mastopexy with superficial fascial system suspension. Plast Reconstr Surg 103:1411–1420CrossRefPubMed
3.
go back to reference Stecco C, Macchi V, Porzionato A, Duparc F, De Caro R (2011) The fascia: the forgotten structure. Ital J Anat Embryol 116:127–138 Archivio italiano di anatomia ed embriologiaPubMed Stecco C, Macchi V, Porzionato A, Duparc F, De Caro R (2011) The fascia: the forgotten structure. Ital J Anat Embryol 116:127–138 Archivio italiano di anatomia ed embriologiaPubMed
4.
go back to reference Lockwood TE (1991) Superficial fascial system (SFS) of the trunk and extremities: a new concept. Plast Reconstr Surg 87:1009–1018CrossRefPubMed Lockwood TE (1991) Superficial fascial system (SFS) of the trunk and extremities: a new concept. Plast Reconstr Surg 87:1009–1018CrossRefPubMed
5.
go back to reference Imanishi N (2011) Adipofascial Structure of the Breast. Jpn J Breast Cancer 26:649–655 Imanishi N (2011) Adipofascial Structure of the Breast. Jpn J Breast Cancer 26:649–655
6.
go back to reference Bostwick JIII (2000) Plastic and Reconstructive Breast Surgery. Quality Medical Publishing Inc, St. Louis Bostwick JIII (2000) Plastic and Reconstructive Breast Surgery. Quality Medical Publishing Inc, St. Louis
7.
go back to reference Benelli L (1990) A new periareolar mammaplasty: the “round block” technique. Aesth Plast Surg 14:93–100CrossRef Benelli L (1990) A new periareolar mammaplasty: the “round block” technique. Aesth Plast Surg 14:93–100CrossRef
8.
go back to reference Cho BC, Yang JD, Baik BS (2008) Periareolar reduction mammoplasty using an inferior dermal pedicle or a central pedicle. J Plast Reconstr Aesthet Surg 61:275–281CrossRefPubMed Cho BC, Yang JD, Baik BS (2008) Periareolar reduction mammoplasty using an inferior dermal pedicle or a central pedicle. J Plast Reconstr Aesthet Surg 61:275–281CrossRefPubMed
9.
go back to reference Hinderer UT (2001) Circumareolar Dermo-Glandular Plication: a New Concept for Correction of Breast Ptosis. Aesth Plast Surg 25:404–420CrossRef Hinderer UT (2001) Circumareolar Dermo-Glandular Plication: a New Concept for Correction of Breast Ptosis. Aesth Plast Surg 25:404–420CrossRef
10.
go back to reference Sarrabayrouse M, Loustau H, Mayer H (2006) Versatility of the 360° periareolar approach for the treatment of mammary pathology. Aesth Plast Surg 30:9–14CrossRef Sarrabayrouse M, Loustau H, Mayer H (2006) Versatility of the 360° periareolar approach for the treatment of mammary pathology. Aesth Plast Surg 30:9–14CrossRef
11.
go back to reference Spear SL, Kassan M, Little JW (1990) Guidelines in concentric mastopexy. Plast Reconstr Surg 85:961–966CrossRefPubMed Spear SL, Kassan M, Little JW (1990) Guidelines in concentric mastopexy. Plast Reconstr Surg 85:961–966CrossRefPubMed
Metadata
Title
Anatomy of the Superficial Layer of Superficial Fascia Around the Nipple-Areola Complex
Authors
Takako Komiya
Norihito Ito
Ryutaro Imai
Masahiro Itoh
Munekazu Naito
Jun Matsubayashi
Hajime Matsumura
Publication date
01-04-2015
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 2/2015
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-015-0455-2

Other articles of this Issue 2/2015

Aesthetic Plastic Surgery 2/2015 Go to the issue