Farouk, A., Zidan, A., Mohamed, A. (2020). Lateral Wings Suspension Technique for Improving the Results of Inferior-Pedicle Breast Reduction in Patients Attending Main University Hospital of Alexandria, Egypt. The Egyptian Journal of Plastic and Reconstructive Surgery, 43(3), 453-462. doi: 10.21608/ejprs.2020.68191
Adham Farouk; Ahmed A Zidan; Ali Gaber A Mohamed. "Lateral Wings Suspension Technique for Improving the Results of Inferior-Pedicle Breast Reduction in Patients Attending Main University Hospital of Alexandria, Egypt". The Egyptian Journal of Plastic and Reconstructive Surgery, 43, 3, 2020, 453-462. doi: 10.21608/ejprs.2020.68191
Farouk, A., Zidan, A., Mohamed, A. (2020). 'Lateral Wings Suspension Technique for Improving the Results of Inferior-Pedicle Breast Reduction in Patients Attending Main University Hospital of Alexandria, Egypt', The Egyptian Journal of Plastic and Reconstructive Surgery, 43(3), pp. 453-462. doi: 10.21608/ejprs.2020.68191
Farouk, A., Zidan, A., Mohamed, A. Lateral Wings Suspension Technique for Improving the Results of Inferior-Pedicle Breast Reduction in Patients Attending Main University Hospital of Alexandria, Egypt. The Egyptian Journal of Plastic and Reconstructive Surgery, 2020; 43(3): 453-462. doi: 10.21608/ejprs.2020.68191
Lateral Wings Suspension Technique for Improving the Results of Inferior-Pedicle Breast Reduction in Patients Attending Main University Hospital of Alexandria, Egypt
The Department of General Surgery, Plastic Surgery Unit, Faculty of Medicine, Alexandria University, Egypt
Abstract
Background: The inferior pedicle wise pattern breast reduction is one of the most popular techniques used. However, a major criticism of inferior pedicle technique is bottoming out of the breast and lack of upper pole fullness. This is caused by gravitational pressure of the breast parenchyma/pedicle on the inferior pole with subsequent scaphoid appearance in the upper pole and lengthening of the vertical scar. In this study, a modification of the inferior pedicle technique will be done by creation of two lateral dermal flaps alongside with the inferior pedicle, and using these flaps to suspend the pedicle to the chest wall and prevent its descent to evaluate its effect on prevention of bottoming out of the breast. Patients and Methods: This is a prospective randomized study that included 20 healthy female patients suffering from breast hypertrophy and they are candidate for reduction mammoplasty by the proposed technique. Design of skin marking for inferior pedicle breast reduction technique was carried out with the standard wise pattern with the creation of two wings (medial and lateral) at the middle of the inferior pedicle; composed of de-epithelialized dermal flaps. Buttressing these two wings to the pectoral fascia at the suitable distances would create a sort of an internal bra effect; which supports the inferior pedicle. During the follow up, the length of the vertical scar (as an indicator of bottoming out) was measured immediately postoperative and every 3 months in the follow-up period. Results: This study includes 20 female patients of an age ranged between 22-51 years old and a breast size (suprasternal notch to nipple distance) ranging from 31 to 44cm. The followup for 1-year post-operative shows change in the areola to fold distance by a ratio satisfaction reaching 60%. Conclusion: From this study we concluded that the inferior pedicle suspension to pectoral fascia improve the result shape of the breast and decrease the bottoming out of the breast.
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