Dr. Robert Whitfield explains why surgeons can't plan breast lifts from photos alone. The nipple-areolar complex is a three-dimensional structure with blood supply and nerves that extend deep beneath the skin. Photos miss skin quality, tissue thickness, scar tissue, and capsular contracture, requiring hands-on assessment instead.
I think it helps to think of the nipple-areolar complex as part of this entire 3-dimensional structure. If you want to think of it the way we view it in the operating room, it's not something that's like a sticker that comes off and on the skin. Its position is obviously very visible on the surface, but its circulation, nervous supply, tissue attachments continue below the surface. And as a surgeon, when I'm planning a lift, It's not simply cutting a circle around it and just kind of moving it or popping it, like I said, off and on. We want everything in continuity. And that's also why photographs don't completely answer questions. You can certainly have some thoughts about them, but it doesn't show you the skin quality, obviously the amount of breast tissue, especially in a case where you're doing an explant, and you can't because of that, assess tissue thickness. You can't have any idea about the underlying scar tissue typically. You can see obvious, like, uh, capsular contractures sometimes if they're really significant. So I do visualize those a lot in 2-dimensional photography.
