Superior Pedicle Reduction Mammoplasty Supported by Central Glandular Pedicle | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 10, Volume 45, Issue 3, July 2021, Page 185-191 PDF (9.43 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2021.183881 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Mohamed A. Megahed* 1; Yaser Elsheikh1; Qutaibah AlKindari2; Mohammad S. Ismail3 | ||||
| 1The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Menoufia University*, Egypt | ||||
| 2Al Babtain Center for Burn, Plastic and Reconstructive Surgery, Ministry of Health**, Kuwait | ||||
| 3Al 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 | ||||
| Superior pedicle; Reduction; Mammoplasty; Glandular; Pedicle | ||||
| 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 | ||||
|
Statistics Article View: 226 PDF Download: 326 |
||||
