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The ANA, is the “cherry on the cake”, a major element in the aesthetic harmony of the breast. It is usually positioned at the tip of the breast and of the same size on each breast, but there may be anomalies such as:

 

On the nipple

 

  • TOO LARGE (hypertrophic nipple): an intervention (usually under local anaesthetic) makes it possible to reduce the volume and thus avoid the nipples “showing through a tee-shirt” (especially if implants have been inserted);
  • TOO INVERTED (inverted or invaginated nipple): an intervention (under local anaesthetic with possible neuroleptic pain-killers) will make it possible to bring the nipples out of inversion; if the inversion is recent a mammogram will be performed to eliminate the possibility of an underlying breast tumour.

 

On the areola

 

  • TOO WIDE, (often in the context of breast hypertrophy or ptosis), the operation will leave a scar around the areola (combined with other scars in the case of breast hypertrophy) thus making it possible to reduce the diameter;
  • TOO SMALL, (often in the context of breast hypotrophy), the only solution is usually tattooing;
  • TOO PROMINENT, (falling within the definition of tuberous breasts), the operation, one that is very difficult to perform, consists in making a peri-areolar incision leaving a scar, cutting through the deep fibrous ring which keeps the areola in place and spreading the mammary gland. It is sometimes necessary to insert a breast implant.

 

On both

 

  • ANA TOO LOW or ECCENTRIC: this generally falls into the category of mammary ptosis and justifies breast surgery, but it is sometimes isolated and very difficult if not impossible to correct;
  • ANA TOO HIGH : (generally after breast reduction) , almost impossible to correct if there is no excess skin;
  • ANA ABSENT or AMPUTATED due to a mastectomy. This can benefit from reconstruction by tattooing or by skin graft (taken from the opposite areola in the case of excess or at the genito-crural fold where the thigh meets the torso).

 

See the SOFCPRE information file

 

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