Necrosis of the NAC is a condition that penalizes patients who underwent breast reduction surgery or mastopexy. Breast
reduction is a widely used technique for over-sized breasts. Breast hypertrophy, in fact, can cause the onset of many
issues - both aesthetical and pathological - because of the excessive weight that the breasts exert on the patient\u2019s spine.
Aim and objective of our study is to suggest a systematic use of diagnostic imaging composed of pre-operative and intraoperative
ultrasound with color-Doppler and pre-operative MRI.
Trying to solve this problem definitively, we relied on our notions of anatomy on ten fresh cadavers, on whose twenty
breasts we could make very detailed dissections. The dissections led us to conclude that, albeit with their anatomic differences,
each breast was characterized by a vascular-nervous pedicle coming out from the inter-costal spaces and aimed
to the blood supply to the NAC. To overcome the anatomic variations between one subject and another - but also
between one breast and the other from the same patient, we relied on diagnostic imaging, both in the pre-operative and
in the intra-operative staging. This way we were able to intervene successfully with 15 patients, none of which has complained
damages to the vascularity or innervation of the NAC so far. In conclusion we believe that pre and intra operative
diagnostic imaging is the only way to completely eliminate any potential risk of NAC necrosis. Only by means of
the systematic use of conventional imaging - especially during surgery - it is possible to constantly monitor the position
of the NAC\u2019s pedicle in a breast that is being reduced in volume
