How to Avoid Nipple Necrosis in Lifting and Reduction Mammaplasties

Partial or complete nipple areolar complex (NAC) necrosis following breast reduction mammaplasties is an overwhelming complication for both the plastic surgeon and the patient. Its reported incidence vary from 2% for full-thickness necrosis to 11% for superficial epidermolysis. Early identification and management of NAC vascular insufficiency is important in order to avoid total NAC loss. The Total Posterior Pedicle breast reduction technique described by Richard Moufarrege in 1982 consists of dissecting the skin away from the breast tissue offering free access to all breast quadrants. This technique is known for its preservation of the breastfeeding function, for its conservation of the nipple erogenous sensation, and for its low rate of long-term complications such as pseudoptosis. In this article, we demonstrate that the Moufarrege Total Posterior Pedicle has an absolute secure blood supply to the NAC and no risk of NAC necrosis.