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Journal of Plastic, Reconstructive &... Mar 2019The superomedial pedicle reduction mammaplasty has been noted in the literature to provide superior aesthetic results and longevity as well as shorter operative times.... (Review)
Review
BACKGROUND
The superomedial pedicle reduction mammaplasty has been noted in the literature to provide superior aesthetic results and longevity as well as shorter operative times. However, the inferior pedicle continues to be the most commonly utilized technique in the United States. There is a lack of large-volume outcome studies examining how the superomedial pedicle technique compares against more established reduction methods.
METHODS
A retrospective review of 938 reduction mammaplasties was performed at a single institution over a 10-year period. A literature review of superomedial and inferior pedicle complication rates were performed. Study variables were compared against overall mean complication rates for the two techniques. Logistic regression, paired student T-Tests, and Chi-square analyses were used to calculate adjusted odds ratios and to compare continuous and categorical variables.
RESULTS
Mean reduction weight was 730 g per breast, ranging from 100 to 4700 g. Overall complication rate was 16%, of which 10% were minor complications related to delayed wound healing. No cases of skin flap necrosis occurred. Increased complications were highly correlated with a BMI > 30, breast reduction weights > 831 g, and sternal notch to nipple distances > 35.5 cm.
CONCLUSIONS
The superomedial pedicle reduction mammaplasty technique is safe and reliable with a complication rate lower than the inferior pedicle technique. Based on our findings we propose that residents should be exposed to this method of reduction mammaplasty as part of a compilation of techniques learned in residency and that practicing surgeons would benefit from becoming familiar with its applications.
Topics: Breast; Female; Humans; Mammaplasty; Retrospective Studies; Surgical Flaps
PubMed: 30579911
DOI: 10.1016/j.bjps.2018.12.004 -
Plastic and Reconstructive Surgery Oct 1993
Topics: Adult; Cicatrix; Female; Follow-Up Studies; Humans; Mammaplasty
PubMed: 8415994
DOI: No ID Found -
Annals of Plastic Surgery Jan 2007
Review
Topics: Female; Humans; Mammaplasty; Nipples; Sensation; Sexuality
PubMed: 17197935
DOI: 10.1097/01.sap.0000250648.70177.4a -
Plastic and Reconstructive Surgery Feb 2023Oncoplastic breast reduction has been shown to be an effective and safe approach to breast conservation surgery in women with macromastia. However, there remains a...
BACKGROUND
Oncoplastic breast reduction has been shown to be an effective and safe approach to breast conservation surgery in women with macromastia. However, there remains a paucity of data investigating the comparative outcomes. This study seeks to delineate the complication profiles for oncoplastic and symmetrizing breast reductions versus mammaplasty for benign macromastia.
METHODS
A retrospective review was conducted of all consecutively performed reduction mammaplasty cases at a single institution by two plastic surgeons over a 2-year period.
RESULTS
A total of 632 breasts were analyzed: 502 reduction mammaplasties, 85 symmetrizing reductions, and 45 oncoplastic reductions in 342 patients. Mean age was 43.9 ± 15.93 years, mean body mass index was 29.15 ± 5.66 kg/m2, and mean reduction weight was 610.03 ± 313.13 g. Regarding surgical technique, a medial pedicle was used in 86% of cases. There were similar postoperative complication outcomes for nipple necrosis, wound healing, scar revision, fat necrosis, seroma, hematoma, and overall complication rates for all procedures. However, the rate of postoperative revision among reduction mammaplasty (2%), oncoplastic reduction (6.7%), and symmetrizing reduction (5.9%) was significantly different (P = 0.027). In univariate analysis, diabetes (P = 0.011), smoking (P = 0.007), higher body mass index (P = 0.003), larger reduction weight (P = 0.011), longer nipple-to-inframammary fold measurement (P = 0.014), and longer sternal notch-to-nipple measurement (P = 0.039) were all significant risk factors for a surgical complication in reductions performed for any indication. Using a multivariate logistic regression model, diabetes (P = 0.047), smoking (P = 0.025), and higher body mass index (P = 0.002) were all retained as statistically significant risk factors.
CONCLUSION
The complication profiles for both oncoplastic breast reductions and breast reductions for symptomatic macromastia are similar and acceptably low.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Therapeutic, III.
Topics: Female; Humans; Adult; Middle Aged; Treatment Outcome; Mammaplasty; Hypertrophy; Nipples; Retrospective Studies; Postoperative Complications
PubMed: 36696305
DOI: 10.1097/PRS.0000000000009828 -
Plastic and Reconstructive Surgery Dec 2007Vertical mammaplasty is an effective alternative to inverted-T methods. Among other benefits, it results in a significantly reduced scar pattern. There exists a subset...
BACKGROUND
Vertical mammaplasty is an effective alternative to inverted-T methods. Among other benefits, it results in a significantly reduced scar pattern. There exists a subset of patients with mild macromastia and minimal ptosis who are candidates for a scar pattern that is further reduced. These patients are usually young and have limited enlargement of the areolae. The upper half of the circumareolar incision can be deleted in these patients to result in a Y-shaped scar pattern. This technique is also applicable to some patients seeking mastopexy with augmentation.
METHODS
Ten patients meeting the criteria described were treated with Y-scar vertical mammaplasty and were reviewed retrospectively.
RESULTS
Eight patients had breast reduction or mastopexy and two patients had mastopexy with augmentation. The average amount of tissue removed from each breast in the reduction group was 198 g (range, 76 to 382 g). The average follow-up period was 8.4 months. Problems encountered were minor and included inferior areolar fullness in three patients and an inverted nipple in one patient. One patient developed a unilateral lower pole deformity several months after surgery that required corrective surgery. All patients were pleased with their final surgical outcome.
CONCLUSIONS
The Y-shaped scar incision design is useful in appropriate candidates to further reduce the scar burden associated with vertical mammaplasty. Retaining the normal transition from pigmented areolar skin to adjacent lighter skin in the upper half of the areola significantly reduces the perception of the overall scar pattern.
Topics: Adolescent; Adult; Cicatrix; Esthetics; Female; Follow-Up Studies; Humans; Mammaplasty; Middle Aged; Retrospective Studies; Skin Pigmentation
PubMed: 18090736
DOI: 10.1097/01.prs.0000287129.47374.84 -
Aesthetic Surgery Journal Jun 2023
Topics: Female; Adolescent; Humans; Mammaplasty; Breast
PubMed: 36928560
DOI: 10.1093/asj/sjad061 -
Clinics in Plastic Surgery Oct 2015
Topics: Breast Implants; Female; Humans; Mammaplasty
PubMed: 26408448
DOI: 10.1016/j.cps.2015.07.001 -
Aesthetic Surgery Journal Oct 2023Loss of sensation is one of the most feared complications of breast reduction surgery. Although several techniques have been proposed to maximize sensitivity...
Loss of sensation is one of the most feared complications of breast reduction surgery. Although several techniques have been proposed to maximize sensitivity preservation, the scientific literature still reports contradictory findings. This systematic review aimed to assess whether breast reduction mammaplasty is associated with measurable changes in breast sensation. This review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed (National Institutes of Health, Bethesda, MD), Scopus (Elsevier, Amsterdam, the Netherlands), and Web of Science (Clarivate, Philadelphia, PA) databases were searched for clinical studies investigating breast sensation after breast reduction mammaplasty. The initial search identified 1523 studies of which 22 articles met our specific inclusion criteria. Most of the included studies are consistent in describing only transient sensation decrease or even sensation improvement after surgery compared to the presurgery condition with any approach, except those investigating outcomes after superior or superolateral pedicle reduction mammaplasty. Nevertheless, the overall quality of evidence is low or very low due to the limited availability of randomized controlled trials or controlled studies and the high risk of bias.
Topics: Female; Humans; Breast; Mammaplasty; Mastectomy; Sensation; Netherlands
PubMed: 37462608
DOI: 10.1093/asj/sjad234 -
Journal of Plastic, Reconstructive &... Jan 2023The benefits of reduction mammoplasty procedures have been reported previously. However, to control the rise in public healthcare costs, we need to find ways of...
BACKGROUND
The benefits of reduction mammoplasty procedures have been reported previously. However, to control the rise in public healthcare costs, we need to find ways of conducting these procedures safely and more cost-effectively. Our aim was to examine whether reduction mammaplasty performed in an outpatient setting has comparable surgical complication rates to those performed in an inpatient setting. We also investigated whether any savings gained from day surgery are still present after any possible indirect costs are considered.
METHODS
The study population comprised 276 patients who underwent reduction mammaplasty in a single center between January 2019 and February 2021. Data were collected from patient medical records. The costs associated with the primary procedure and any possible additional expenses were calculated. Basic statistical comparisons were performed for propensity score-matched data.
RESULTS
Complication rates, readmissions, number of contacts to the health care system, and need for additional surgical interventions were comparable between outpatients and inpatients. The basic costs for outpatients were 2990 euros per patient and 3923 euros for inpatients. Total costs after possible extra expenses were lower in day surgery as it was markedly more cost-effective than patients treated as inpatients.
CONCLUSIONS
Reduction mammaplasties can be safely performed in an outpatient setting. Moreover, the emergence of complications is comparable to those performed in an inpatient setting. An outpatient setting produced significant cost savings not only in the immediate costs of primary surgery but also in the costs associated with possible complications and extra contacts to the healthcare system.
Topics: Female; Humans; Retrospective Studies; Ambulatory Surgical Procedures; Mammaplasty; Breast; Health Care Costs; Postoperative Complications
PubMed: 36521263
DOI: 10.1016/j.bjps.2022.10.027 -
Plastic and Reconstructive Surgery Dec 2005
Topics: Cicatrix; Female; History, 20th Century; Humans; Mammaplasty; Treatment Outcome
PubMed: 16327619
DOI: 10.1097/01.prs.0000191197.21528.26