Zidan, A., Azzam, E., Elkafrawy, H. (2020). Keyhole Pattern with Superior-Medial Pedicle in Large Breast Reduction. The Egyptian Journal of Plastic and Reconstructive Surgery, 43(3), 463-468. doi: 10.21608/ejprs.2020.68195
Ahmed Zidan; Ehab Z Azzam; Hossam Elkafrawy. "Keyhole Pattern with Superior-Medial Pedicle in Large Breast Reduction". The Egyptian Journal of Plastic and Reconstructive Surgery, 43, 3, 2020, 463-468. doi: 10.21608/ejprs.2020.68195
Zidan, A., Azzam, E., Elkafrawy, H. (2020). 'Keyhole Pattern with Superior-Medial Pedicle in Large Breast Reduction', The Egyptian Journal of Plastic and Reconstructive Surgery, 43(3), pp. 463-468. doi: 10.21608/ejprs.2020.68195
Zidan, A., Azzam, E., Elkafrawy, H. Keyhole Pattern with Superior-Medial Pedicle in Large Breast Reduction. The Egyptian Journal of Plastic and Reconstructive Surgery, 2020; 43(3): 463-468. doi: 10.21608/ejprs.2020.68195
Keyhole Pattern with Superior-Medial Pedicle in Large Breast Reduction
The Department of General Surgery, Plastic Surgery Unit, Faculty of Medicine, Alexandria University, Egypt
Abstract
Background: Breast surgery is one of the most difficult fields of aesthetic surgery, because of the complexity of surgical procedures and the relative guidelines defining the aesthetically perfect breast. The goal in reduction mammaplasty is to achieve a pleasing balance among size, shape, and projection of the breast with optimal sensation and appropriate blood supply for the nippleareola and breast. These goals are challenged by the amount of excess tissue and severely distorted breast landmarks in massive breast hypertrophy and severe breast ptosis. The traditional treatment for massive breast hypertrophy or severe breast ptosis is breast amputation with free grafting of the nipple-areola or inverted T, inferior pedicle used to have a relatively high number of complications and the disadvantage. On the other hand, relying on inverted T, superior-medial pedicle can avoid the disadvantage of the previse techniques and give reliable, stable and pleasant results in large reduction mammoplasties. 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 superior-medial pedicle breast reduction technique was carried out with the standard Wise pattern. The amount of removed tissue was recorded, the aesthetic result and patient satisfaction was estimated for the results. Results: This study includes 20 female patients of an age ranged between 24-45 years old and a breast size (suprasternal notch to nipple distance) ranging from 33 to 42cm. The weight of removed tissues during surgery in our study was ranging from 1210 to 1970. We found that 75% of our results are of excellent aesthetic results, 15% good and 10% fair with 70% of patients were satisfied, 20% of patients were somewhat satisfied/somewhat dissatisfied and 10% of patients were dissatisfied. Conclusion: From this study we concluded that the keyhole pattern with superior medial pedicle was an efficient technique for excising more tissue in large breasts with pleasant aesthetic results.
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