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Mastopexy and Breast Reduction

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Evidence-Based Cosmetic Breast Surgery

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Abstract

Vertical mastopexy and breast reduction are the same operation, differentiated only by the resection weight. The vertical technique converts an elliptical defect to a straight-line closure. The length dividend increases projection and produces conical lower poles. Breast shape is improved, with less scarring than the Wise pattern. Nonvertical mammaplasties have geometric limitations, including nipple overelevation, boxiness, and reduced breast projection.

A medially based pedicle and intraoperative nipple siting are recommended. A short, inverted-T modification is used when the vertical scar extends below the level of the new (elevated) inframammary fold. A mosque dome often creates an inverted teardrop deformity.

Surprisingly, in 60% of women with ptotic breasts, both nipples are located at or above the breast apex, suggesting that the nipple slides with the breast in most cases rather than on it.

Vertical breast reduction effectively inverts the breast parenchymal ratio. The mean increase in breast projection after vertical mastopexy is 1.2 cm. Upper pole projection increases 0.5 cm. The increment in breast projection is about half as much after breast reduction – 0.6 cm on both sides. These modest increases confirm the clinical impression that mastopexy and reduction cannot duplicate the effect of a breast implant.

Nipple transposition on long pedicles is unnecessary. Using the vertical method, 80% of the upward nipple movement derives from breast mound elevation; only 20% comes from nipple repositioning on the breast mound. Short pedicles reduce the incidence of nipple loss to almost none. Persistent ptosis is the most common indication for reoperation. Adequate lower pole parenchymal resection is needed to prevent persistent ptosis. Skin-only mastopexies are usually ineffective.

Vertical mammaplasties facilitate combination (“mommy makeover”) procedures. Operating times for vertical mammaplasties, typically 1–2 h, are about an hour shorter than for inverted-T procedures, with less blood loss. Outpatient surgery is the norm.

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References

  1. Nahai F. Clinical decision-making in breast surgery. In: Nahai F, editor. The art of aesthetic surgery. Principles & techniques. St. Louis: Quality Medical Publishing; 2005. p. 1818.

    Google Scholar 

  2. Swanson E. Prospective outcome study of 106 cases of vertical mastopexy, augmentation/mastopexy, and breast reduction. J Plast Reconstr Aesthet Surg. 2013;66:937–49.

    Article  PubMed  Google Scholar 

  3. Gorney M. Ten years’ experience in aesthetic surgery malpractice claims. Aesthet Surg J. 2001;21:569–71.

    Article  CAS  PubMed  Google Scholar 

  4. Spear SL, Pelletiere CV, Menon N. One-stage augmentation combined with mastopexy: aesthetic results and patient satisfaction. Aesthet Plast Surg. 2004;28:259–67.

    Article  Google Scholar 

  5. Rohrich RJ, Gosman AA, Brown SA, Reisch J. Mastopexy preferences: a survey of board-certified plastic surgeons. Plast Reconstr Surg. 2006;118:1631–8.

    Article  CAS  PubMed  Google Scholar 

  6. Swanson E. Prospective photographic measurement study of 196 cases of breast augmentation, mastopexy, augmentation/mastopexy, and breast reduction. Plast Reconstr Surg. 2013;131:802e–19e.

    Article  CAS  PubMed  Google Scholar 

  7. Swanson E. Photometric evaluation of inframammary crease level after cosmetic breast surgery. Aesthet Surg J. 2010;30:832–7.

    Article  PubMed  Google Scholar 

  8. Swanson E. Comparison of vertical and inverted-T mammaplasties using photographic measurements. Plast Reconstr Surg Glob Open. 2013;1:e89.

    Article  PubMed  Google Scholar 

  9. Swanson E. Prospective comparative clinical evaluation of 784 consecutive cases of breast augmentation and vertical mammaplasty, performed individually and in combination. Plast Reconstr Surg. 2013;132:30e–45e; discussion 46e–7e.

    Google Scholar 

  10. Swanson E. A retrospective photometric study of 82 published reports of mastopexy and breast reduction. Plast Reconstr Surg. 2011;128:1282–301.

    Article  CAS  PubMed  Google Scholar 

  11. McCulley SJ, Hudson DA. Short-scar breast reduction: why all the fuss? Plast Reconstr Surg. 2001;107:965–9.

    Article  CAS  PubMed  Google Scholar 

  12. Regnault P, Daniel RK, Tirkanits B. The minus-plus mastopexy. Clin Plast Surg. 1988;15:595–600.

    CAS  PubMed  Google Scholar 

  13. Hall-Findlay EJ. Pedicles in vertical breast reduction and mastopexy. Clin Plast Surg. 2002;29:379–91.

    Article  PubMed  Google Scholar 

  14. Swanson E. All seasons vertical augmentation mastopexy: a simple algorithm, clinical experience, and patient-reported outcomes. Plast Reconstr Surg Glob Open. 2016;4:e1170.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Karp NS. Mastopexy and mastopexy augmentation. In: Thorne CH, editor. Grabb and Smith’s plastic surgery. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 585–92.

    Google Scholar 

  16. Lejour M. Vertical mammaplasty: update and appraisal of late results. Plast Reconstr Surg. 1999;104:771–81.

    Article  CAS  PubMed  Google Scholar 

  17. Karp NS. Medial pedicle/vertical breast reduction made easy. The importance of complete inferior glandular resection. Ann Plast Surg. 2004;52:458–64.

    Article  PubMed  Google Scholar 

  18. Flowers RS, Smith EM. “Flip-flap” mastopexy. Aesthet Plast Surg. 1998;22:425–9.

    Article  CAS  Google Scholar 

  19. Bames HO. Breast malformations and a new approach to the problem of the small breast. Plast Reconstr Surg. 1950;5:499–506.

    Article  CAS  Google Scholar 

  20. Aufricht G. Mammaplasty for pendulous breasts. Empiric and geometric planning. Plast Reconstr Surg. 1949;4:13–29.

    Article  CAS  Google Scholar 

  21. Maliniac JW. Breast deformities and their repair. New York: Grune & Stratton; 1950. p. 129.

    Google Scholar 

  22. Hidalgo DA. Vertical mammaplasty. Plast Reconstr Surg. 2005;115:1179–1197; discussion 1198.

    Google Scholar 

  23. Lista F, Ahmad J. Vertical scar reduction mammaplasty: a 15-year experience including a review of 250 consecutive cases. Plast Reconstr Surg. 2006;117:2152–65.

    Article  CAS  PubMed  Google Scholar 

  24. Hall-Findlay EJ. A simplified vertical reduction mammaplasty: shortening the learning curve. Plast Reconstr Surg. 1999;104:748–59.

    Article  CAS  PubMed  Google Scholar 

  25. McKissock PK. Discussion. Avoiding the flat breast in reduction mammaplasty. Plast Reconstr Surg. 1980;66:69–70.

    Article  Google Scholar 

  26. Góes JCS. Periareolar mammaplasty: double-skin technique with application of mesh support. Clin Plast Surg. 2002;29:349–64.

    Article  Google Scholar 

  27. Adams Jr WP, Toriumi DM, Van Natta BW. Clinical use of GalaFLEX in facial and breast cosmetic surgery. Aesthet Surg J. 2016;36(S2):S23–32.

    Article  PubMed  Google Scholar 

  28. Maliniac JW. Evaluation of principal mammaplastic procedures. Plast Reconstr Surg. 1949;4:359–73.

    Article  CAS  Google Scholar 

  29. Regnault P, Daniel RK. Aesthetic plastic surgery. Principles and techniques. Boston: Little Brown; 1984. p. 549.

    Google Scholar 

  30. Puckett CL, Meyer VH, Reinisch JF. Crescent mastopexy and augmentation. Plast Reconstr Surg. 1985;75:533–9.

    Article  CAS  PubMed  Google Scholar 

  31. Brink RR. Evaluating breast parenchymal maldistribution with regard to mastopexy and augmentation mammaplasty. Plast Reconstr Surg. 2000;106:491–6.

    Article  CAS  PubMed  Google Scholar 

  32. Gorney M. Patient selection – the illusion and the reality. In: Proceedings of the senior residents conference, Milwaukee, March 19–20, 2004; p. 1–29.

    Google Scholar 

  33. Spear SL, Giese SY, Ducic I. Concentric mastopexy revisited. Plast Reconstr Surg. 2001;107:1294–9.

    Article  CAS  PubMed  Google Scholar 

  34. Lalonde DH, Lalonde J, French R. The no vertical scar breast reduction: a minor variation that allows to remove vertical scar portion of the inferior pedicle wise pattern T scar. Aesthet Plast Surg. 2003;27:335–44.

    Article  Google Scholar 

  35. White CP, Khoee HF, Kattan AE, Farrokhyar F, Hynes NM. Breast reduction scars: a prospective survey of patient preferences. Aesthet Surg J. 2013;33:817–21.

    Article  PubMed  Google Scholar 

  36. Swanson E. Limitations of the horizontal (no vertical scar) breast reduction. Aesthet Surg J. 2014;34:195–6.

    Article  PubMed  Google Scholar 

  37. Adams WP. Discussion. In search of better shape in mastopexy and reduction mammoplasty. Plast Reconstr Surg. 2002;110:321–2.

    Article  Google Scholar 

  38. Biggs T. Presented at: Meeting of the American Society for Aesthetic Plastic Surgery; May 2, 2002; Las Vegas.

    Google Scholar 

  39. Arie G. Una nueva técnica de mastoplastia. Rev Latinam Cir Plast. 1957;3:23–8.

    Google Scholar 

  40. Pitanguy I. Surgical treatment of breast hypertrophy. Br J Plast Surg. 1967;20:78–85.

    Article  CAS  PubMed  Google Scholar 

  41. Lassus C. Update on vertical mammaplasty. Plast Reconstr Surg. 1999;104:2289–98.

    Article  CAS  PubMed  Google Scholar 

  42. Marchac D, de Olarte G. Reduction mammaplasty and correction of ptosis with a short inframammary scar. Plast Reconstr Surg. 1982;69:45–55.

    Article  CAS  PubMed  Google Scholar 

  43. Aubert V. Hypertrophie mammaire de la puberté. Résection partielle restauratrice. Arch Franco-Belges de Chir. 1923;3:284–9.

    Google Scholar 

  44. Kraske H. Die operation der atrophischen und hypertrophie schen hängebrust. Münch Med Wschr. 1923;60:672.

    Google Scholar 

  45. Dartigues L. Esthetique mammaire. Traitement chirurgical du prolapsus mammaire. Arch Franco-Belges Chir. 1925;28:313–28.

    Google Scholar 

  46. Lexer E. Zur operation der mammahypertrophie und der hängebrust. Dtch Med Wschr. 1925;51:26.

    Article  Google Scholar 

  47. Passot R. La correction esthétique du prolapsus mammaire par la procédé de transposition du memelon. Presse Méd. 1925;33:317–8.

    Google Scholar 

  48. Biesenberger H. Deformitäten und kosmetische operationen der weiblichen brust. Wilhem Mandrich: Wien; 1931.

    Google Scholar 

  49. Pickford MA, Boorman JG. Early experience with the Lejour vertical scar reduction mammaplasty technique. Br J Plast Surg. 1993;46:516–22.

    Article  CAS  PubMed  Google Scholar 

  50. Ritz M, Silfen R, Southwick G. Fascial suspension mastopexy. Plast Reconstr Surg. 2006;117:86–94.

    Article  CAS  PubMed  Google Scholar 

  51. Grotting JC, Chen SM. Control and precision in mastopexy. In: Nahai F, editor. The art of aesthetic surgery. Principles & techniques. St. Louis: Quality Medical Publishing; 2005. p. 1907–50.

    Google Scholar 

  52. Swanson E. A measurement system for evaluation of shape changes and proportions after cosmetic breast surgery. Plast Reconstr Surg. 2012;129:982–92.

    Article  CAS  PubMed  Google Scholar 

  53. Hall-Findlay EJ. Reduction mammaplasty. In: Nahai F, editor. The art of aesthetic surgery. Principles & techniques. St. Louis: Quality Medical Publishing; 2005. p. 1951–2043.

    Google Scholar 

  54. Swanson E. The case against chemoprophylaxis for venous thromboembolism prevention and the rationale for SAFE anesthesia. Plast Reconstr Surg Glob Open. 2014;2:e160.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Swanson E, Gordon R. Comparing a propofol infusion with general endotracheal anesthesia in plastic surgery patients. Aesthet Surg J. Published online February 18, 2017.

    Google Scholar 

  56. Doppler Ultrasound Imaging of Plastic Surgery Patients for DVT Detection. Available at: http://clinicaltrials.gov/ct2/show/NCT02123550?term=Doppler+ultrasound+plastic+surgery+Swanson&rank=1. Accessed 30 Nov 2016.

  57. Hanna MK, Nahai F. Applied anatomy of the breast. In: Nahai F, editor. The art of aesthetic surgery: principles & techniques. St. Louis: Quality Medical Publishing; 2005. p. 1790–815.

    Google Scholar 

  58. Eder M, Klöppel M, Müller D, et al. 3-D analysis of breast morphology changes after inverted T-scar and vertical scar reduction mammaplasty over 12 months. J Plast Reconstr Aesthet Surg. 2013;66:776–86.

    Article  PubMed  Google Scholar 

  59. Hall-Findlay EJ. Discussion. Simplifying the vertical reduction mammaplasty. Plast Reconstr Surg. 2004;113:173–4.

    Article  Google Scholar 

  60. Wise RJ. A preliminary report on a method of planning the mammaplasty. Plast Reconstr Surg. 1956;17:367–75.

    Article  CAS  Google Scholar 

  61. Berthe J-V, Massaut J, Greuse M, Coessens B, DeMey A. The vertical mammaplasty: a reappraisal of the technique and its complications. Plast Reconstr Surg. 2003;111:2192–2202; discussion 2200–2.

    Google Scholar 

  62. Mathes SJ, Nahai F, Hester TR. Avoiding the flat breast in reduction mammaplasty. Plast Reconstr Surg. 1980;66:63–8.

    Article  CAS  PubMed  Google Scholar 

  63. Hester TR, Bostwick J, Miller L, Cunningham SJ. Breast reduction utilizing the maximally vascularized central breast pedicle. Plast Reconstr Surg. 1985;76:890–900.

    Article  PubMed  Google Scholar 

  64. Reus WF, Mathes SJ. Preservation of projection after reduction mammaplasty: long-term follow-up of the inferior pedicle technique. Plast Reconstr Surg. 1988;82:644–50.

    Article  CAS  PubMed  Google Scholar 

  65. Nahabedian MY, McGibbon BM, Manson PN. Medial pedicle reduction mammaplasty for severe mammary hypertrophy. Plast Reconstr Surg. 2000;105:896–904.

    Article  CAS  PubMed  Google Scholar 

  66. Chen C, White C, Warren SM, Cole J, Isik FF. Simplifying the vertical reduction mammaplasty. Plast Reconstr Surg. 2004;113:162–172; discussion 173–4.

    Google Scholar 

  67. Georgiade NG, Serafin D, Riefkohl R, Georgiade GS. Is there a reduction mammaplasty for “all seasons?”. Plast Reconstr Surg. 1979;63:765–73.

    Article  CAS  PubMed  Google Scholar 

  68. Chalekson CP, Neumeister MW, Zook EG, Russell RC. Outcome analysis of reduction mammaplasty using the modified Robertson technique. Plast Reconstr Surg. 2002;110:71–81.

    Article  PubMed  Google Scholar 

  69. Dinner MI, Chait LA. Preventing the high-riding nipple after McKissock breast reduction. Plast Reconstr Surg. 1977;59:330–3.

    Article  CAS  PubMed  Google Scholar 

  70. Regnault P. Breast ptosis. Clin Plast Surg. 1976;3:193–203.

    CAS  PubMed  Google Scholar 

  71. Lejour M. Vertical mammaplasty: early complications after 250 personal consecutive cases. Plast Reconstr Surg. 1999;104:764–70.

    Article  CAS  PubMed  Google Scholar 

  72. Cruz-Korchin N, Korchin L. Vertical versus wise pattern breast reduction: patient satisfaction, revision rates, and complications. Plast Reconstr Surg. 2003;112:1573–1578; discussion 1579–81.

    Google Scholar 

  73. Spector JA, Kleinerman R, Culliford AT, Karp NS. The vertical reduction mammaplasty: a prospective analysis of patient outcomes. Plast Reconstr Surg. 2006;117:374–381; discussion 382–3.

    Google Scholar 

  74. Hofmann AK, Wuestner-Hofmann MC, Bassetto F, Scarpa C, Mazzoleni F. Breast reduction: modified “Lejour technique” in 500 large breasts. Plast Reconstr Surg. 2007;120:1095–1104; discussion 1105–07.

    Google Scholar 

  75. Amini P, Stasch T, Theodorou P, Altintas AA, Phan V, Spilker G. Vertical reduction mammaplasty combined with a superomedial pedicle in gigantomastia. Ann Plast Surg. 2010;64:279–85.

    Article  CAS  PubMed  Google Scholar 

  76. Adham M, Sawan K, Lovelace C, Jaeger NJ, Adham C. Unfavorable outcomes with vertical reduction mammaplasty: part II. Aesthet Surg J. 2011;31:40–6.

    Article  PubMed  Google Scholar 

  77. Neaman KC, Armstrong SD, Mendonca SJ, et al. Vertical reduction mammaplasty utilizing the superomedial pedicle: is it really for everyone? Aesthet Surg J. 2012;32:718–25.

    Article  PubMed  Google Scholar 

  78. Hunter-Smith DJ, Smoll NR, Marne B, Maung H, Findlay MW. Comparing breast-reduction techniques: time-to-event analysis and recommendations. Aesthet Plast Surg. 2012;36:600–6.

    Article  CAS  Google Scholar 

  79. Hall-Findlay EJ. Breast reduction: modified “Lejour technique” in 500 large breasts (discussion). Plast Reconstr Surg. 2007;120:1105–7.

    Article  CAS  Google Scholar 

  80. Stevens WG, Freeman ME, Stoker DA, Quardt SM, Cohen R, Hirsch EM. One-stage mastopexy with breast augmentation: a review of 321 patients. Plast Reconstr Surg. 2007;120:1674–9.

    Article  CAS  PubMed  Google Scholar 

  81. Swanson E. Seroma prevention in abdominoplasty: eliminating the cause. Aesthet Surg J. 2016;36:NP23–4.

    Article  PubMed  Google Scholar 

  82. Stevens WG, Gear AJL, Stoker DA, et al. Outpatient reduction mammaplasty: an eleven-year experience. Aesthet Surg J. 2008;28:171–9.

    Article  CAS  PubMed  Google Scholar 

  83. Cunningham BL, Gear AJL, Kerrigan CL, Collins ED. Analysis of breast reduction complications derived from the BRAVO study. Plast Reconstr Surg. 2005;115:1597–604.

    Article  CAS  PubMed  Google Scholar 

  84. Serra MP, Longhi P, Sinha M. Breast reduction with a superomedial pedicle and a vertical scar (hall-Findlay’s technique): experience with 210 consecutive patients. Ann Plast Surg. 2010;64:275–8.

    Article  CAS  PubMed  Google Scholar 

  85. Dabbah A, Lehman JA, Parker MG, Tantri D, Wagner DS. Reduction mammaplasty: an outcome analysis. Ann Plast Surg. 1995;35:337–41.

    Article  CAS  PubMed  Google Scholar 

  86. Schnur PL, Schnur DP, Petty PM, Hanson TJ, Weaver AL. Reduction mammaplasty: an outcome study. Plast Reconstr Surg. 1997;100:875–83.

    Article  CAS  PubMed  Google Scholar 

  87. Henry SL, Crawford JL, Puckett CL. Risk factors and complications in reduction mammaplasty: novel associations and preoperative assessment. Plast Reconstr Surg. 2009;124:1040–6.

    Article  CAS  PubMed  Google Scholar 

  88. Hunter JG, Ceydeli A. Correlation between complication rate and tissue resection volume in inferior pedicle reduction mammaplasty: a retrospective study. Aesthet Surg J. 2006;26:153–6.

    Article  CAS  PubMed  Google Scholar 

  89. Roehl K, Craig ES, Gómez V, Phillips LG. Breast reduction: safe in the morbidly obese? Plast Reconstr Surg. 2008;122:370–8.

    Article  CAS  PubMed  Google Scholar 

  90. Wagner DS, Alfonso DR. The influence of obesity and volume of resection on success in reduction mammaplasty: an outcomes study. Plast Reconstr Surg. 2005;115:1034–8.

    Article  CAS  PubMed  Google Scholar 

  91. Gamboa-Bobadilla GM, Killingsworth C. Large-volume reduction mammaplasty: the effect of body mass index on postoperative complications. Ann Plast Surg. 2007;58:246–9.

    Article  CAS  PubMed  Google Scholar 

  92. Chun Y, Schwartz MA, Gu X, Lipsitz SR, Carty M. Body mass index as a predictor of postoperative complications in reduction mammaplasty. Plast Reconstr Surg. 2012;129:228e–33e.

    Google Scholar 

  93. Setälä L, Papp A, Joukainen S, et al. Obesity and complications in breast reduction surgery: are restrictions justified? J Plast Reconstr Aesthet Surg. 2009;62:195–9.

    Article  PubMed  Google Scholar 

  94. Rohrich RJ, Coberly DM, Krueger JK, Brown SA. Planning elective operations on patients who smoke: survey of north American plastic surgeons. Plast Reconstr Surg. 2002;109:350–5.

    Article  PubMed  Google Scholar 

  95. Bartsch RH, Weiss G, Kastenbauer T, et al. Crucial aspects of smoking in wound healing after breast reduction surgery. J Plast Reconstr Aesthet Surg. 2007;60:1045–9.

    Article  PubMed  Google Scholar 

  96. Bikhchandani J, Varma SK, Henderson HP. Is it justified to refuse breast reduction to smokers? J Plast Reconstr Aesthet Surg. 2007;60:1050–4.

    Article  CAS  PubMed  Google Scholar 

  97. Hudson DA. Repeat reduction mammaplasty. Plast Reconstr Surg. 1999;104:401–8.

    Article  CAS  PubMed  Google Scholar 

  98. Losee JE, Caldwell EH, Serletti JM. Secondary reduction mammaplasty: is using a different pedicle safe? Plast Reconstr Surg. 2000;106:1004–8.

    Article  CAS  PubMed  Google Scholar 

  99. Ahmad J, McIsaac SM, Lista F. Does knowledge of the initial technique affect outcomes after repeated breast reduction? Plast Reconstr Surg. 2012;129:11–8.

    Article  CAS  PubMed  Google Scholar 

  100. Pollock H, Pollock T. Is reoperation rate a valid statistic in cosmetic surgery? Plast Reconstr Surg. 2007;120:569.

    Article  CAS  PubMed  Google Scholar 

  101. Kerrigan C. Maximizing outcomes in breast reduction surgery: a review of 518 consecutive patients (discussion). Plast Reconstr Surg. 2005;116:1640–1.

    Article  CAS  Google Scholar 

  102. Swanson E. Prospective study of lidocaine, bupivacaine and epinephrine levels and blood loss in patients undergoing liposuction and abdominoplasty. Plast Reconstr Surg. 2012;130:702–722; discussion 723–5.

    Google Scholar 

  103. Regnault P. Nipple hypertrophy. A physiologic reduction by circumcision. Clin Plast Surg. 1975;2:391–6.

    CAS  PubMed  Google Scholar 

Download references

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    Eric Swanson MD

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Swanson, E. (2017). Mastopexy and Breast Reduction. In: Evidence-Based Cosmetic Breast Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-53958-4_6

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