• Archives of Plastic Surgery
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• v.36 no.3
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• pp.327-332
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• 2009

Purpose: Several methods of the nipple reduction have been reported. However, the methods described previously are difficult or have some demerits. This study proposes a simple technique for reduction of the nipple height as well as diameter. Methods: The purposed nipple height is marked. A pentahedral design of excision was marked around the nipple. Local anesthetic solution was infiltrated and a 4 - 0 Nylon traction suture was applied at the nipple apex. Excision of the nipple inside both two triangles and a rectangle was made. Remaining two flaps were approximated using 5 - 0 Nylon simple interrupted sutures. However, a part of wound closure was not done in the central area of the nipple. Results: 83 patients(166 nipples) underwent this procedure from December 1999 to December 2008. Follow up ranged from 6 months to 2 years with a mean of 10 months. 78 patients were female and 5 patients were male. No major complication occurred and remaining scars were very inconspicuous. Conclusion: This simple technique has the advantage of nipple reduction in both height and diameter, and provides good aesthetic outcomes.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.422-427
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• 2009

Purpose: Breast cancer is second most common cancer in women. Almost of patients with breast cancer treated with mastectomy undergoes breast reconstruction. Nipple reconstruction is an important step in breast reconstruction. Many surgeons have investigated of nipple reconstruction using the flap technique after breast reconstruction with the autologous tissue. The objective of this study is to evaluate the results of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. Methods: From April 2006 to May 2008, the authors treated 17 patients of nipple reconstruction using C - V flap technique, who were received breast reconstruction with the only breast expander. We have predicted decrease of the size of reconstructed nipple and designed flap a little larger than wanted nipple size. Nipple splint was applied for 4 - 6 months for minimizing decrease of the size of reconstructed nipple. The diameter and height of the reconstructed nipple were measured and patient's satisfaction score was assessed. Results: Mean follow-up duration was 12.5 months. Among the 17 patients, the average absorption rate by height of nipple was 47.0%. Partial necrosis was noted in 1 case, and treated well with conservative management. There was no other significant complications noted. Patient's satisfactory score was assessed by the height, design and location of the nipple. The average of satisfaction score was 85%, 68%, 62% and total average was 83%. Conclusion: The authors experienced 17 patients of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. The absorption rate of the size of the nipple, complications and patient's satisfactory score of this study were similar to those of nipple reconstruction after breast reconstruction with the autologous tissue. It is expected that nipple reconstruction after breast reconstruction with the only breast expander is safe and reliable. It is considered that a long - term study is necessary.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.237-244
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• 2005

Although the technique of vertical reduction mammaplasty has gained major popularity, it is difficult to perform and has the steep learning curve. The authors present a modification of the standard Lejour vertical mammaplasty that simplify the design and make it more reliable and easy to perform. We simplified the design by discarding the Mosque dome. From March 2000 to March 2004, we performed this technique for 40 patients with breast hypertrophy. The apex of the design was marked at the anterior projection of the inframammary fold. After resection of the breast tissue, the medial and lateral pillars were approximated. Then a new nipple-areola position was determined at 4.0-5.0 cm from a new inframammary fold. The range of resection amount of breast tissues was from 150 to 750 gram. Most of the patients were satisfied with the results. There was no permanent sensory loss and nipple areola skin necrosis. But there was 1 case of hematoma on the first day after the operation. This technique presents several advantages. It allows shaping and projection without compromising the future nipple position and makes it easier to remove an excessive skin around the areolae. And it may be comfortable to adjust the position of the nipple at the end of the procedure. We believe that this modification helps to improve the results of the vertical reduction mammaplasty.

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.748-752
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• 2014

Background Gynecomastia is benign enlargement of breast tissue in males and is fairly common. Mastectomy not only helps in improving the shape of anterior chest, but can also improve the location of nipple. Therefore, a principle element of mastectomy design is defining the normal location of nipple based on major anatomical reference points. Here, the nipple location was compared for before and after gynecomastia surgery. In addition, the same was also compared between male patients undergoing gynecomastia surgery and control group of subjects without gynecomastia. Methods We retrospectively analyzed gynecomastia patients who underwent conventional subcutaneous mastectomy. Preoperative and postoperative anatomical landmark distances and chest circumferences were measured and compared to the same anthropometric data from 20 healthy adult male controls. Results Nipple locations were compared among 13 patients and 20 controls. The mean weight of resected breast tissue was 246 g, and overall patient satisfaction grade was 4.3 out of 5. In the patient group, the slopes for the height-distance from the sternal notch to the nipple and chest circumference-distance between the mid-line of the sternum and the nipple were 0.175 and 0.125 postoperatively, respectively. The slopes of the control group were 0.122 and 0.177, respectively; these differences were statistically significant (P<0.05). Conclusions Nipple positions were considerably lower in patients with gynecomastia than in control subjects. Subcutaneous mastectomy was associated with mild elevations, but postoperative locations were still lower compared to controls. Further efforts are needed to improve the location of postoperative nipple-areola complex in patients with gynecomastia.

• Journal of the Korean Society of Mechanical Technology
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• v.20 no.6
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• pp.865-871
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• 2018

The 3-way valve have been used as a valve for opening and closing the valve by the flow control in the pressure system of the cryogenic and high pressure environment. In this paper, numerical analysis and experimental study on fracture nipple of 3-way ultra high pressure valve applied to space launch vehicle was carried out. We have developed a 3-way valve numerical simulation modeler of cryogenic environment using commercial software ANSYS 18.2. As results of numerical analysis, optimum nipple condition was derived. In addition, a 3-way valve prototype was fabricated and the fracture test was performed and compared with the numerical analysis results.

• Archives of Plastic Surgery
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• v.46 no.4
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• pp.324-329
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• 2019

Background Multiple approaches for nipple reconstruction exist, and none is considered superior to all others. The star flap is one of the most popular methods for nipple reconstruction, but gradual height loss is a major concern. We present a new modification of the star flap that incorporates a de-epithelialized dermal flap, along with the associated surgical results. Methods We reviewed the medical records of patients who underwent nipple reconstruction using the modified star flap method. The design was different from the conventional star flap in that the lateral wings were changed into a trapezoidal shape and de-epithelialized dermal flaps were added. The patients were followed up at 2, 4, 6, and 12 months postoperatively, and nipple height was measured. The postoperative nipple height achieved using the modified method was compared with that obtained using the traditional method. Results From February 2013 to June 2017, 32 patients received surgery using the modified star flap, and 18 patients who underwent nipple reconstruction before 2013 comprised the conventional method group. All patients had undergone breast reconstruction with an abdominal tissue-based flap. The mean follow-up period was 14.4 months in the modified method group and 17.3 months in the conventional method group. The mean maintenance of projection at 12 months postoperatively was $56.28%{\pm}18.58%$ in the modified method group, and $44.23%{\pm}14.15%$ in the conventional method group. This difference was statistically significant (P<0.05). Conclusions The modified method using a de-epithelialized dermal flap provides reliable maintenance of projection in patients who have undergone abdominal tissue-based breast reconstruction.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.695-698
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• 2010

Purpose: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. Methods: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a $2.8{\times}3.1\;cm$-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. Results: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. Conclusion: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.

• Asian-Australasian Journal of Animal Sciences
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• v.21 no.1
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• pp.120-123
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• 2008

This experiment was conducted to investigate the effect of different nipple angles on water disappearance in growing pigs, which is defined as the water which leaves the watering device but is not consumed by the pig. This water adds to the volume of the total waste slurry. Four crossbred pigs averaging $70.0{\pm}1.4$ kg were assigned into 1 of 4 treatments using a $4{\times}4$ Latin-square design. Treatments were distinguished by the angle between nipple terminal and the perpendicular wall. These angles were: 1) NA-30 (= Nipple Angle $30^{\circ}$), 2) NA-45 (= Nipple Angle $45^{\circ}$), 3) NA-60 (= Nipple Angle $60^{\circ}$) and 4) NA-90 (= Nipple Angle $90^{\circ}$). All of the nipples were fixed at shoulder height of each pig. After a 7-day adaptation period, samples were collected from each pig for 4 days, followed by a day for change-over. Pigs were fed a 0.8 kg diet twice daily at 08:00 and 20:00 and supplied water ad libitum. Throughout the experimental period, pigs in the NA-30 treatment group showed greater water disappearance than other treatments. Water disappearance was the lowest for the NA-60 treatment group (p<0.01). The percentage of water disappearance to the water supply was significantly reduced in the NA-60 treatment group (p<0.01). Water intake was the same for all the treatment groups. The rate of water disappearance per unit of water intake was significantly decreased in pigs in the NA-60 treatment group compared to other groups (p<0.01). These results suggested that the nipple angle for growing pigs should be $60^{\circ}$ to reduce water disappearance and, subsequently, the amount of waste generated.

• Journal of the Korean Society of Manufacturing Process Engineers
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• v.12 no.6
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• pp.101-108
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• 2013

An aircraft fuel hose is a kind of high pressure hose, and generally consists of a nipple, a socket, an inner tube, and a reinforcement layer to increase the tensile strength. Especially the nipple supports the other components in manufacturing stages such as the swaging or crimping processes however, the nipple also serves to prevent leakage in cases of hose engagement with a hydraulic system. To ensure the seal of the hose assembly, a beam seal fitting with metal-to-metal contact is usually adopted at the end of a nipple. Therefore, the geometry of the beam is an important parameter to be determined to make sure there is sufficient contact force. This study aims to investigate the effects of beam seal geometry on the contact force by changing the inclined angle and the thickness of the beam. The results reveal that the proper thickness and inclined angle of the beam seal are 0.45 mm and $8.5^{\circ}$, respectively.

• Journal of Fashion Business
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• v.20 no.4
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• pp.189-206
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• 2016

A breast model was for the human body was devised by studying a body scan and human body index of a desirable breast type. Thus, when manufacturing various 3D models, these results can accordingly become a fundamental basis for realizing a desirable breast model. This study aims to provide a basic data for designing the cup patterns of brassieres in order to improve the function and wearing comfort. The comfort of three kinds of brassieres were compared: one manufactured by the actual measured size; another manufactured as per the ratio of desirable upper and lower breast lengths; and the third manufactured by the 3D model attained by the desirable human body ratio. In this study, we suggest a process for realizing the desirable breast model using the ratio of bust breadth and waist front length, which are the components for deciding the appropriate position and size of breast, and which are easy to measure. The ideal breast shape is an equilateral triangle formed by connecting the nipple with the center of the clavicle. After deciding the interval between the nipples, this value can be used to configure the locations of nipples by drawing a tangent, with equal length, from the anterior neck point (which is the center of clavicle) to the nipple. Also, since inside points of breast do not exist, the outer point of breast, upper point of breast, and below point of breast on the same plane, and the depths from the nipple point to the respective points, are applied to simulate a 3D image, by modifications along the x, y, and z axes. Depending on the type of breast, the length from the center of shoulder to the nipple, the diameter of breast, upper length of breast, and the position of nipple, are different. In conical or protruding breast, the wearing sensation is better when the nipple point of brassiere was lifted, by modifying the upper and lower lengths of breast. Considering the wearing sensation and function of a brassiere, it was better to leave the wearer's size as it is and use a pad within the same cup, rather than increase the basal area of the breast in order to increase the volume.