Reduction mammaplasty using inferior pedicle technique combined with dermal suspension

Abstract

Reduction mammaplasty is one of the most frequently performed aesthetic breast surgery. Among the different techniques that provide reliable results, inferior pedicle technique with inverted T-scar has been widely used for many years. It is a safe and simple technique especially for the patients with massive macromastia and severe ptosis [1]. The main disadvantage of this technique is loss of shape over time as a result of sagging of the remaining breast tissue behind the submammary fold and as a consequence, upward distortion of the plane of nipple-areola complex [2]. Many other reduction mammaplasty techniques also can produce good results, but few make it possible to prevent secondary ptosis as they rely on support of skin envelope that redrapes over the gland [3]. Additional measures to prevent ptosis are described in literature. These are fixa-tion and suspension sutures of the remaining gland to the pectoral fascia [4, 5], glandular shaping and stabilization [4, 5] or allogenic mesh [4, 6, 7]. The use of strips of dermis graffor stabilization was indicated by Maliniac [8, 9], followed by Lewis [10], Da Silva [11], and Hinderer [12]. Menesi [13] presented his distally based dermal flap for glandular fixation and support. Goes [6] used a circular flap of dermis with a central pedicle in the areolar region. All these techniques aimed at achieving a permanent pleasant shape that would oppose gravitational forces that create continuous ptotic effect. On the basis of the advantages of dermal suspension, we used inferior pedicle technique with inverted T-scar combined with suspension of two laterally extended triangular dermal flaps. © 2009 Springer-Verlag Berlin Heidelberg.