For aesthetic reasons, plastic surgeons are sometimes required to re-position male nipples – after dramatic weight-loss for example. In such a case they are presented, in effect, with a substantially blank canvas. But the presently accepted methods for calculating ideal nipple locations are far from straightforward.

“Currently available guidelines create areolas that are too large, place the nipple-areola complex too high and too far medially, and/or require complex abstract mathematical calculations.”

- explain Dr. Bishara Atiyeh and colleagues at the Beirut Medical Center, Lebanon, who have together developed an entirely new scientific method for male nipple re-positioning. It makes use of the so-called ‘Golden Ratio‘  (also known as the ‘Divine Proportion‘) which has been much admired and utilised by architects, artists and sculptors – stretching at least as far back as the Renaissance.

“Relying on the recently appreciated aesthetic value of the golden number Phi (ϕ) we propose an easy and reliable method to determine the horizontal and vertical coordinates of the male nipples. With only 2 easily measurable distances, umbilicus-anterior axillary fold apex and umbilicus-suprasternal notch, the internipple distance and the position of the horizontal nipple plane relative to the suprasternal notch can be calculated.”

- say the researchers, clarifying how their new and substantially simpler nipple-positioning method can achieve outstanding levels of precision.

“The internipple distance can be determined with 95% accuracy and the distance from the suprasternal notch can be determined in 80% of cases within a range of 3.33 ± 1.25 cm.”

The authors remind us though that slight mal-positioning of the male nipples can be tolerated – pointing out too that

“… exact determination of internipple distance is more ‘eye catching’ and aesthetically important than the vertical location of the NN [Nipple-Nipple] plane.“

In the final analysis, however, the aesthetic and manual skills of the plastic-surgeon-as-artist still remain paramount.

”Even with the accuracy attainable with the best formulae, final surgical decisions must be dictated by the surgeon’s sense of sculptural form as there still is no substitute for adequate preoperative evaluation and surgical talent, experience, and skill.”

The research paper ‘Vertical and Horizontal Coordinates of the Nipple-Areola Complex Position in Males’ was published in Annals of Plastic Surgery : November 2009 – Volume 63 – Issue 5 – pp 499-502.