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. 2025 Apr;49(8):2252-2259.
doi: 10.1007/s00266-024-04403-5. Epub 2024 Nov 25.

Use of the Thermal Camera to Assess the Perfusion of the Nipple-Areola Complex and Lower Adipoglandular Flap in Post-Explantation Mastopexy

Alberto M Lacouture  1 , Marco E Guerrero  2 , Natalia A Lacouture  3 , Ricardo E Manzur  3
Affiliations

Use of the Thermal Camera to Assess the Perfusion of the Nipple-Areola Complex and Lower Adipoglandular Flap in Post-Explantation Mastopexy

Alberto M Lacouture et al. Aesthetic Plast Surg. 2025 Apr.

Abstract

Thermography is a valuable tool for assessing tissue temperature. In recent years, explantation surgery has increased due to the fact that, despite technological advancements, breast implants have a limited lifespan and eventually require explantation, whether for pathological, aesthetic, or personal reasons. Among the complications that can arise in breast surgery are necrosis of the nipple-areola complex (NAC) and fat necrosis of the lower dermoglandular flap, which may affect the outcomes. Considering that the blood supply and perfusion of the breast were altered during the initial surgical procedure, and the technique previously used is often unknown, it is crucial to ensure adequate vascularization of the NAC and the flap. This study demonstrates the usefulness of the thermal camera for intraoperative and postoperative monitoring of the NAC and the lower adipoglandular flap, with the goal of determining tissue perfusion and identifying hypoperfused areas for immediate management, thus providing a new safety parameter in breast surgery.Level of Evidence V 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 .

Keywords: Breast reconstruction; Breast surgery safety; Perfusion; Thermal image; Thermography.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no conflicts of interest to disclose. Ethical Approval: All procedures involving human participants were conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed Consent: All patients involved in this study provided informed consent and agreed to the use of their images for medical research.

Figures

Fig. 1
Fig. 1
a Intraoperative image showing the lower flap and the nipple-areola complex (NAC) individualized. b Thermographic image of the flap showing hypoperfusion, with purple coloration at its distal end. c Image of the resection of the distal end of the lower flap. d Thermographic image of the lower flap with no purple coloration, indicating adequate perfusion at its distal end
Fig. 2
Fig. 2
a Image of the right breast with markings for the superior pedicle technique. b Thermographic image showing the incidental finding of the breast implant’s location, characterized by lower temperature and clear delimitation
Fig. 3
Fig. 3
Case 1 a Preoperative photograph of the left breast with surgical markings: superior pedicle (red), lower adipoglandular flap (green). b Preoperative thermographic image. c Intraoperative photograph showing the NAC (nipple-areola complex) and adipoglandular flap. d Intraoperative thermographic image of the NAC and flap. e Immediate postoperative photograph with T-technique. f Postoperative thermographic image of the NAC and flap, showing temperatures approaching preoperative levels
Fig. 4
Fig. 4
Case 2 a Preoperative photograph of the right breast with surgical markings: superior pedicle (red), lower flap (green). b Preoperative thermographic image. c Intraoperative photograph showing the NAC (nipple-areola complex) and lower flap. d Intraoperative thermographic image of the NAC and flap. e Immediate postoperative photograph with L-technique. f Postoperative thermographic image of the NAC and flap, showing temperatures approaching preoperative levels
Fig. 5
Fig. 5
Preoperative and postoperative images of case 1 and 2 displayed in Figs. 3 and 4
See this image and copyright information in PMC

References

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