• Archives of Plastic Surgery
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• v.42 no.5
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• pp.601-607
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• 2015

Background Autologous or implant-based breast reconstruction after nipple-sparing mastectomy is increasingly preferred worldwide as a breast cancer treatment option. However, postoperative nipple-areola complex (NAC) necrosis is the most significant complication of nipple-sparing mastectomy. The purpose of our study was to identify the risk factors for NAC necrosis, and to describe the use of our skin-banking technique as a solution. Methods We reviewed cases of immediate autologous breast reconstruction after nipple-sparing mastectomy at our institution between June 2005 and January 2014. The patients' data were reviewed and the risk of NAC necrosis was analyzed based on correlations between patient variables and NAC necrosis. Moreover, data pertaining to five high-risk patients who underwent the donor skin-banking procedure were included in the analysis. Results Eighty-five patients underwent immediate autologous breast reconstruction after nipple-sparing mastectomy during the study period. Partial or total NAC necrosis occurred in 36 patients (43.4%). Univariate analysis and binary regression modeling found that body mass index, smoking history, radiation therapy, and mastectomy volume were significantly associated with NAC necrosis. Of the 36 cases of NAC necrosis, 31 were resolved with dressing changes, debridement, or skin grafting. The other five high-risk patients underwent our prophylactic skin-banking technique during breast reconstruction surgery. Conclusions NAC necrosis is common in patients with multiple risk factors. The use of the skin-banking technique in immediate autologous breast reconstruction is an attractive option for high-risk patients. Banked skin can be used in such cases without requiring additional donor tissue, with good results in terms of aesthetic and reconstructive outcomes.

• Archives of Plastic Surgery
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• v.41 no.4
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• pp.407-413
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• 2014

Background Implant malposition can produce unsatisfactory aesthetic results after breast augmentation. The goal of this article is to identify aspects of the preoperative surgical planning and intraoperative flap fixation that can prevent implant malposition. Methods This study examined 36 patients who underwent primary dual plane breast augmentation through an inframammary incision between September 1, 2012 and January 31, 2013. Before the surgery, preoperative evaluation and design using the Randquist formula were performed. Each patient was evaluated retrospectively for nipple position relative to the breast implant and breast contour, using standardized preoperative and postoperative photographs. The average follow-up period was 10 months. Results Seven of 72 breasts were identified as having implant malposition. These malpositions were divided into two groups. In relation to the new breast mound, six breasts had an inferiorly positioned and one breast had a superiorly positioned nipple-areolar complex. Two of these seven breasts were accompanied with an unsatisfactory breast contour. Conclusions We identified two main causes of implant malposition after inframammary augmentation mammaplasty. One cause was an incorrect preoperatively designed nipple to inframammary fold (N-IMF) distance. The breast skin and parenchyma quality, such as an extremely tight envelope, should be considered. If an extremely tight envelope is found, the preoperatively designed new N-IMF distance should be increased. The other main cause of malposition is failure of the fascial suture from Scarpa's fascia to the perichondrium through an inframammary incision. As well, when this fixation is performed, it should be performed directly downward to the perichondrium, rather than slanted in a cranial or caudal direction.

• Archives of Plastic Surgery
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• v.33 no.1
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• pp.101-106
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• 2006

Nipple reconstruction is an important step in breast reconstruction after mastectomy. The authors' preferred reconstructive technique is the local C-V flap in case that a small opposite nipple is not adequate for composite graft. This flap produces an excellent reconstruction, but it is not easy to produce an adequate projection and firmness of the nipple. This article describes the technique and experience in nine patients treated over two years with dermis(scar tissue) graft for nipple reconstruction. This is the first report of application of autologous dermis(scar tissue) grafting to reconstruct a nipple primarily after breast mound reconstruction, decreasing the absorption of the reconstructed nipple and increasing the hardness. The dermis(scar tissue) is taken from scar revision and/or dog-ear correction in the second stage operation after free TRAM flap breast reconstruction. And the dermis(scar tissue) graft is inserted vertically between the local flaps and horizontally under the reconstructed nipple base. Between September 2002 and February 2005, nine patients underwent C-V flap with dermis(scar tissue) graft as a part of their nipple reconstruction. The patient's ages ranged from 28 to 55 years old (mean, 41.1 years old). The follow-up period ranged from 5 to 35 months, with an average of 14.5 months. None of the nipples showed skin flap necrosis or local infection, and uneventful wound healing. Our result showed good nipple projection with less absorption and enough firmness. Our experiences shows that dermis(scar tissue) grafts in C-V flap is a very useful method for nipple reconstruction.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.11
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• pp.5834-5840
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• 2013

Along with the development of high-speed, wired and wireless Internet technology, various harmful images in a form of photos and video clips have become prevalent these days. In this paper, we suggest a method of automatically detecting adult images by extracting woman's nipple areas which represent obscenity of the image. The suggested algorithm first segments skin color areas in the $YC_bC_r$ color space from input images and extracts nipple's candidate areas from the segmented skin areas through the suggested nipple map. We then select real nipple areas by using geometrical information and determines input images as harmful images if they contain nipples. Experimental results show that the suggested nipple map-based method effectively detects adult images.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.550-555
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• 2014

Background Nipple reconstruction following breast mound reconstruction is the final step in breast reconstruction. Although nipple reconstruction is a simple surgery, the psychological aspects of nipple reconstruction are thought to be important. Nipple projection is a key factor in determining patient satisfaction with the surgery. In the present study, the Hammond flap technique was introduced for nipple reconstruction. Methods Twenty-six patients who had undergone breast reconstruction from February 2008 to March 2012 were enrolled in this prospective study. All patients were evaluated based on preoperative photos, and their nipple diameters and heights were measured. Postoperative evaluation was conducted 3, 6, 9, and 12 months following nipple reconstruction. A questionnaire on patient satisfaction with the nipple reconstruction was administered 12 months after nipple reconstruction. Moreover, the same plastic surgeon scored nipple projection and overall cosmetic result of the new nipple. Results The mean projection was 4.4 mm (range, 3-6 mm), and it well matched the contralateral nipple. Twelve months following nipple reconstruction, the mean reduction rate in the nipple projection was 43.6%. Patients were satisfied or very satisfied with the nipple projection and the overall cosmetic result in 80.7% cases. Conclusions In the present study, compared with other techniques, the use of the Hammond flap technique in nipple reconstruction showed competitive results with regard to nipple projection and patient satisfaction.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.553-558
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• 2013

Background Skin-sparing mastectomy with immediate breast reconstruction is increasingly becoming a proven surgical option for early-stage breast cancer patients. Areola-sparing mastectomy (ASM) has also recently become a popular procedure. The purpose of this article is to investigate the reconstructive and aesthetic issues experienced with one-stage nipple and breast reconstruction using ASM. Methods Among the patients who underwent mastectomy between March 2008 and March 2010, 5 women with a low probability of nipple-areolar complex malignant involvement underwent ASM and immediate breast reconstruction with simultaneous nipple reconstruction using the modified C-V flap. The cosmetic outcomes of this series were reviewed by plastic surgeons and patient self-assessment and satisfaction were assessed via telephone interview. Results During the average 11-month follow-up period, there were no cases of cancer recurrence, the aesthetic outcomes were graded as excellent to very good, and all of the patients were satisfied. Two patients developed a gutter-like depression around the reconstructed nipple, and one patient developed skin erosion in a small area of the areola, which healed with conservative dressing. The other complications, such as necrosis of the skin flap or areola, seroma, hematoma, or fat necrosis did not occur. Conclusions Since one-stage nipple and breast reconstruction following ASM is an oncologically safe, cost-effective, and aesthetically satisfactory procedure, it is a good surgical option for early breast cancer patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.8 no.5
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• pp.961-967
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• 2007

Automatic water feeding system for chickens is the one of the most important devices at poultry farms. Chickens drink water directly from a water feeder nipple of the automatic water feeder. Check valve inside the water feeder nipple is open when they drink water and is closed otherwise. There are two types of nipples. One is the piston nipple, and the other is the ball nipple. Because the nipple stick in the ball nipple can move freely, the sloping mechanism of the ball nipple works well. but it has complicated mechanism. On the other hand, the piston nipple has very simple structure, but its movement is limited so it can move only up-and-down. To overcome those limitation, the piston nipple with sphere valve seat face (sphere face piston nipple) has been developed and is just distributed at domestic markets. The experimental performance test of the commercialized sphere piston nipple has been conducted, and compared with the performance of the ball nipple and the piston nipple which are domestic products. As the result, sphere piston nipple shows excellent performance compared to that of the piston nipple but its performance is similar to ball type nipple.

• Archives of Plastic Surgery
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• v.47 no.1
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• pp.26-32
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• 2020

Background Nipple reconstruction is usually performed as a delayed procedure in patients with breast cancer who undergo skin-sparing mastectomy and breast reconstruction surgery using a deep inferior epigastric perforator (DIEP) flap. The authors designed this study to evaluate the utility of breast reconstruction based on a DIEP flap and immediate nipple reconstruction. Methods A retrospective review was conducted of all patients who underwent breast reconstruction performed by a single plastic surgeon from October 2016 to June 2018. Through a questionnaire and chart review, we compared surgical results and complications in cases of single-stage nipple reconstruction after skin-sparing mastectomy (n=17) with patients who underwent delayed nipple reconstruction after skin-sparing mastectomy, modified radical mastectomy, or simple mastectomy (n=7). Results In a subjective analysis using clinical photos, the immediate nipple reconstruction group had higher scores than their counterparts in an evaluation of the nipple-areolar complex (NAC) (NAC placement, 3.34 vs. 3.04; nipple projection, 3.05 vs. 3.03; nipple size, 3.30 vs. 3.29). No significant differences between the groups were found in terms of complications. Conclusions Simultaneous nipple reconstruction is a reliable surgical method with economic advantages. No differences were found in terms of outcomes and complications in comparison to delayed reconstruction. Therefore, surgeons can consider simultaneous nipple reconstruction without particular concerns about asymmetry or necrosis.

• Journal of Fashion Business
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• v.9 no.6
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• pp.12-28
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• 2005

The purpose of this study is to help develop high quality brassieres with functionality and comfort, fitting adolescents' physical features during their growth period. This study conducts a comparative analysis of juvenile brassiere and adult brassiere to identify the problems of brassieres in the market. The raw data for this study was processed by SPSS 10.1. The results of this study are summarized as follows: 1. The results of this survey show that the girls' satisfaction of their breasts has correlations between breast protrusion degree and volume. The girls think that if they have protrusive breasts their breast volume is big, and their breast satisfaction level shows high. 2. The results show that the objective of brassiere wearing is to prevent breasts sag and rupture, make good breast shape, balance their entire body shape, and make beautiful outer garment line. Brassiere functions are to prevent jiggle of breasts, make a good body line, and cover the nipples. For the grader school students, they are wearing brassiere to make a good balanced body and as their breasts developed, they are wearing brassiere for beautiful body shape not just to cover up their breasts. 3. In regard to brassiere cup size recognition, as students have higher grade at school, they have better recognition abouxt their cup size. As they are better aware of their cup size, they have better satisfaction with their cup size. Therefore, choosing the right size of brassiere for their bust is very important. 4. Girl students' brassiere preference shows that 317 students (56.9%) prefer white for brassiere colors, following pink and flesh color. Their most preferred brassiere material is cotton (354 people, 63.6%) because cotton is not sensitive even for weak skin. For brassiere style, 273 students (49%) prefer round style, following spots and mold. Their most preferred brassiere style is stake. In addition, brassiere should not press their breasts because their breasts are developing during puberty period.

• Fashion & Textile Research Journal
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• v.23 no.5
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• pp.624-633
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• 2021

This study was intended to compare the comfort of wearing each type of commercially available bralette. The trial wearing experiment was conducted on five women in their 20s who wear an average Korean bra size of 70A. The experimental bralettes were of four types: a bralette with both hooks and pads and a bralette without both, a bralette with hooks but no pads, and a bralette with pads but no hooks. The wearing test results are as follows. First, in terms of functional satisfaction, the padded bralette provided the greatest satisfaction in supporting the chest from the bottom up and bringing it to the center, and the bralette without the pad provided the least satisfaction. In addition, the level of convenience of attaching/detaching was about twice as high in the bralette with hooks than those without hooks. Chest compression was found to be greater in bralettes without hooks than in those with hooks. In terms of the pressure on the shoulder strap and on the lower chest band, it was found that bralettes with hooks had a greater sense of pressure than those without. In the appearance characteristics test, the unpadded bralettes scored higher than the padded one in the matter of feeling embarrassed, because in unpadded bralettes, the nipples were exposed underneath the clothes . This study is meaningful in classifying the design of the bralette and evaluating the fit for each design in the absence of prior research on the bralette.