SynthesisAesthetic plastic surgery2026
Management of High-Riding Nipple-Areola Complex: A Systematic Review of Its Prevention and Management.
Synthesis in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal positioning of the nipple-areola complex (NAC) remains a challenging part of breast surgery, with high-riding NAC (HRNAC) frequently occurring postoperatively. An evidence-based summary of all effective prevention and management strategies is needed for a variety of surgical contexts.
objectivesThis systematic review aims to explore and summarise the prevention and corrective strategies for HRNAC across aesthetic and reconstructive breast surgeries. The review evaluates their evidence base and summarises the techniques available.
methodsA PRISMA compliant search of PubMed/Medline was conducted on November 1st, 2024, and the following search terms were used: "nipple AND high AND riding OR malposition AND breast". Data on demographics, surgical technique, outcomes, and levels of evidence were extracted.
results346 articles were screened, yielding 36 after full text screening. Of these, 23 studies included reconstructive surgeries (20 purely reconstructive and 3 mixed), and 13 aesthetic surgeries. For reconstructive surgeries, corrective surgeries included crescent mastopexy, re-draping mastectomy flaps, transposition flaps of various designs, change of implant plane and free nipple grafting. Prevention strategies included suture placement to secure the NAC and implant using various methods, preoperative marking strategies, and maximal filling of the expander. For aesthetic surgeries, preventative strategies also included precise preoperative markings, in addition to intraoperative stabilisation of the envelope and implant pocket. Corrective measures ranged from crescent mastopexy, change in implant plane, local flaps and tissue expansion, amongst others. Outcomes were inconsistently reported and therefore meta-analysis was not possible due to heterogenicity of data. A new evidence-based algorithm is suggested.
conclusionsThis review highlights the broad range of procedures and prevention strategies for correcting HRNAC, representing the challenging nature of the problem. There is a significant lack of objective and consistent outcome reporting. For the future, standardised reporting including patient-reported outcome measures are required. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.