Superior Pedicle Reduction Mammoplasty Supported by Central Glandular Pedicle

Document Type : Original Article

Authors

1 The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Menoufia University*, Egypt

2 Al Babtain Center for Burn, Plastic and Reconstructive Surgery, Ministry of Health**, Kuwait

3 Al Babtain Center for Burn, Plastic and Reconstructive Surgery, Ministry of Health, Kuwait

Abstract

Objectives: To evaluate effect of supporting superior
pedicle by central glandular pedicle in reduction mammoplasty
in improving aesthetic outcome and reducing the incidence
of nipple areola necrosis and postoperative NAC loss of
sensation.
Background: Superior pedicle reduction mammoplasty
provides good aesthetic outcome, but has high possibility of
nipple areola complex loss of sensation, there for keeping the
central glandular portion as support to superior pedicle ensures
good blood and sensory supply to NAC.
Methods: This study included 37 patients presented by
breasts hypertrophy from March 2019 to March 2021. All
patients' breasts were examined for suprasternal notch to
nipple distance, areolar diameter, nipple to infra mammary
fold distance. Postoperative assessment included: Nipple
areola complex vascularity, nipple areola complex sensitivity
and patients' satisfaction about breast contour, projection,
symmetry, scars and overall aesthetic outcome using a score
out of 4. Patients underwent marking using wise pattern for
skin incision. Intraoperative; excision of skin, fat and glandular
tissue inferior to NAC, starting from skin and went directly
to chest wall keeping central breast mound with the superior
pedicle. Finally closure was in vertical or inverted T pattern
according to skin excess to be removed.
Results: In this study we operated upon 37 patients who
were asking for breast reduction aged between 20 and 57
years with mean age 39.6 years. The overall complication
percentage 14.8% excluding poor scarring. We had no cases
of total Nipple areola complex loss, low incidence of nipple
areola complex persistent reduced sensation after 1 year of
follow-up (2.7%) and no complete loss of sensation in any
patient. Aesthetic outcome accepted by 97.3% of patients.
Conclusion: Superior pedicle reduction mammoplasty
supported by central glandular pedicle helps in ensuring
reliable blood perfusion and sensory nerve supply to nipple
areola complex which reduces possibility of post-operative
nipple areola complex necrosis and loss of sensation, while
patient gets pleasant and long standing aesthetic outcome.

Keywords

Main Subjects

References

Patricio Andrades and Arturo Prado. Understanding modern
breast reduction techniques with a simplified approach.
Journal of Plastic, Reconstructive & Aesthetic Surgery,
61: 1284-1293, 2008.
2- Spear S.L. and Howard M.A.: Evolution of the vertical
reduction mammaplasty. Plast. Reconstr. Surg., 112: 855-
868, 2003.
3- Lista F. and Ahmad J.: Vertical scar reduction mammaplasty:
15-year experience including a review of 250
consecutive cases. Plast. Reconstr. Surg., 117 (7): 2152-
2169, 2006.
4- Greuse M., Hamdi M. and DeMey A.: Breast sensitivity
after vertical mammoplasty. Plast. Reconstr. Surg., 107:
970-976, 2001.
5- Coriddi M., Nadeau M., Taghizadeh M. and Taylor A.:
Analysis of satisfaction and well-being following breast
reduction using a validated survey instrument: The
BREASTQ. Plast. Reconstr. Surg., 132: 285-290, 2013.
6- Isaias Vieira Cabral, et al.: Increased Capacity for Work
and Productivity after Breast Reduction. Aesth. Surg. J.,
36: 1-6, 2016.
7- Stevens W.G., Repta R., Pacella S.J., et al.: Safe and
consistent outcomes of successfully combining breast
surgery and abdominoplasty: An update. Aesth. Surg. J.,
29 (2): 129-134, 2009.
8- Schlenz I., Rigel S., Schemper M., et al.: Alteration of
nipple and areola sensitivity by reduction mammaplasty:
A prospective comparison of five techniques. Plast. Reconstr.
Surg., 115: 743-751, 2005.
9- Nadeau M., Gould D., Macias L., Spring M. and Stevens
W.: Superior Pedicle Technique of Reduction Mammaplasty:
A Stepwise Approach Aesthetic Surgery Journal,
Vol. 35 (1): 94-104, 2015.
10- Klinger M., Klinger F., Maione L., Lisa A., Battistini A.,
Giannasi S., Veronesi A., Bandi V., Catania B., Barbera
F., Lozito A., Caviggioli F. and Vinci V.: Superior Pedicle
Breast Reduction with Prefiguration of Final Shape: A
10-year Retrospective Study. Plast. Reconstr. Surg. Glob
Open, 8: e3242, 2020

Files

Share

How to cite

Statistics