Nippin’ Out
July 9th, 2009
I just do not know how else to describe the recent article in Allure Magazine. Quoting a London Daily Mail article about Victoria Beckham, they show a photo of her is a fitted top. The photo prominently displays the shape of her nipples and areola. The article claims surgical enhancement to create this appearance is becoming more popular.
The breast can be separated into three profile components. First is the breast mound, which accounts for the majority of the breast size. Traditional breast enlargement surgery enhances this through placement of an implant beneath the breast and/or muscle. The center portion of the breast is highlighted by the nipple and areola. This is the eye point or where a person looks when they look at another person’s (man or woman) chest. The nipple is the central portion of this area. It projects out from the breast normally. The nipple represents the termination of the breast milk ducts allowing breast feeding. The darker skin around the nipple is known as the areola. Its color varies widely with genetic background and past pregnancy history. The areola is usually flat in relation to the surrounding breast mound. Sometimes this projects above the breast mound to add another contour to the breast. This is apparent in the Allure photo.
There are a variety of cosmetic nipple surgeries. The most common procedure in the past has been correction of inverted nipples. In this condition, the normal milk ducts are too short and cause the central part of the nipple to be drawn inward thus reducing the nipple projection. Correction of inverted nipples eliminates the ability to breast feed and can interfere with nipple sensation. It is important to understand nipple inversion can be a sign of breast cancer. The internal mass can cause scarring of the milk ducts which draw in the nipple. If a patient experiences this inward movement after having normally projecting nipples, they must be evaluated for a possible breast tumor.
Some women are self conscious of nipple prominence. It embarrasses them when they wear clothing. For those women I suggest the use of clear plastic adhesive dressings which flatten the nipples. The dressings are imperceptible beneath clothing.
Other women are requesting increased nipple and sometimes areola projection. There are implants available but these are generally reserved for nipple reconstruction after breast cancer surgery. In addition, there are many reconstructive nipple procedures which use the remaining skin and fat after the cancer surgery to make a new nipple. The potential scarring resulting from these procedures require that they generally keep those surgeries in the realm of reconstruction surgery.
Women considering increased nipple and areola projection might consider temporary fillers like Restylane ® or Juvederm ®. These will be reabsorbed after six to nine months. If there are any reservations regarding the appearance, nothing need be done. A more permanent solution is fat graft injections. Fat taken from another area of the body is transferred with injections to the areola and/or nipple. The result can be permanent but some of the initial improvement will be lost as the body absorbs some of the transferred fat.
Just like clothing and hair styles, this fashionable trend may only be popular only for a season or two. I think temporary solutions to increase nipple and areola projection are the best choices. Any surgery is serious business and it should not be considered frivolously.
Ear Lobe Repair
July 7th, 2009
Ear lobe stretching is really nothing new, although it seems to be quite fashionable now. The tribes near the Ubangi River like the Suyas have been practicing lip stretching for centuries. They find the changes in anatomy to be physically attractive, while culturally consistent. The ability to stretch the skin is one of the remarkable aspects of the human body. The skin not only stretches, but also grows to accommodate stretching force. Similarly results of pregnancy, as it stretches a woman’s abdominal skin is the most familiar. Obesity essentially does the same thing, by gradually stretching skin due to significant weight gain. In many cases, when weight is then lost, stretched skin fails to regain its elasticity and often sags. These permanent changes in anatomy are the reasons why tummy tucks, thigh lifts and arm lifts are done.
Tissue expansion is the purposeful stretching of skin using a “medical saline filled balloon.” When extra skin is needed, plastic surgeons use this device to “grow” extra skin. Breast reconstruction done following cancer surgery is the most common use of this particular technique.
Earlobe stretching, like facial tattoos can become unwanted in western culture due to its cultural inconsistency or changes in current fashion fads. Notions of what is beautiful or desirable are constantly changing perceptions. As a person’s life and life situations change, requests to repair the purposeful ear stretching or remove the tattoo often arrive on my doorstep. Recently a patient with stretched earlobes requested a repair. They were to become employed in a rather conservative company. The stretched earlobe appearance made them feel uncomfortable in their new cultural setting. Repair was simple and easily accomplished, since the largest diameter inserted was no greater than an inch. Unfortunately, stretched areas larger than one inch can pose real reconstruction issues and more complicated surgery is needed to correct large holes made by stretching the skin.
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