Abstract
The critical points which should not be overlooked when performing reduction mammaplasty are to minimize scar on the breast and to ensure a sufficient blood supply for the viability of the nipple-areolar complex. Periareolar reduction mammaplasty has been widely used because it left only one scar around the areola. However, with the typical periareolar reduction mammaplasty technique, it is difficult to remove a large amount of breast tissue and mobilize the remaining breast tissue. It may result in necrosis of the nipple-areolar complex in some cases. To overcome these limitations we combined the periareolar incision with the inferior dermal pedicle, which has a relatively good blood supply. This new technique was employed in 22 consecutive women (44 breasts) with hypertrophy and a varying degree of ptosis. Infiltration of a tumescent solution and liposuction were performed in all cases. After periareolar incision, dissection of the skin was performed, and the breast was elevated from the fascia of the pectoralis major muscle, leaving the inferior dermal pyramidal pedicle. An adequate amount of tissue was resected in the superior, medial, and lateral areas. After mastopexy, closure was done with a purse-string suture. The amount of tissue resected ranged from 180 to 1510 g per breast, and the mean was 466.1 g. The mean length of elevation of the nipple was 10.6 cm along the meridian of the breast. There were a few complications which needed revision operation: hematoma collection in one breast (2.3%), wound dehiscence in one breast (2.3%), and fat necrosis in one breast (2.3%). There was no necrosis of the nipple-areolar complex. With this new technique of periareolar reduction mammaplasty utilizing the inferior dermal pedicle, we were able to minimize the scar, preserve the nipple-areolar complex, and improve the motility of the breast tissue. But we also observed a flat or square appearance in the case of a large amount of resection in the patients with poor skin elasticity. This technique is safe and versatile and produces aesthetically acceptable results in selected patients.
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References
Aboudib JH Jr, de Castro CC: Mammaplasty utilizing the periareolar approach. Aesth Plast Surg22:51, 1998
Bartels RJ, Strickland DM, Douglas WM: A new mastopexy for mild or moderate ptosis. Plast Reconstr Surg57:687, 1976
Benelli L: A new periareolar mammaplasty: The round block technique. Aesth Plast Surg17:301, 1993
Benito J, Sanza IF: Periareolar techniques for mammary reduction and elevation. Aesth Plast Surg17:311, 1993
Busto RA: Periareolar mammaplasty with silicone supporting lamina. Plast Reconstr Surg89:646, 1992
Courtiss EH, Goldwyn RM: Reduction mammaplasty by the inferior pedicle technique. Plast Reconstr Surg59:500, 1977
Dinner MI, Artz JS, Foglietti MA: Application and modification of the circular skin excision and pursestring procedures. Aesth Plast Surg17:301, 1993
Dufourmental C, Mouly R: Mammaplasty by the oblique technique. Ann Chir Plast6:45, 1989
Farina MA, Newby BG, Alani HM: Innervation of the nipple-areolar complex. Plast Reconstr Surg66:497, 1980
Felicio Y: Periareolar reduction mammaplasty. Plast Reconstr Surg88:789, 1991
Georgiade NG, Serafin D, Morris R: Reduction mammaplasty utilizing an inferior pedicle nipple areolar flap. Ann Reconstr Surg3:211, 1979
Hester TR, Bostwick J, Miller L, Cunningham SJ: Breast reduction utilizing the maximally vascularized central breast pedicle. Plast Reconstr Surg76:890, 1985
Lassus C: Breast reduction: Evolution of a technique—A single vertical scar. Aesth Plast Surg2:107, 1987
Lejour M: Vertical mammaplasty and liposuction of the breast. Plast Reconstr Surg94:100, 1994
Marchac D, de Olarte G: Reduction mammaplasty and correction of ptosis with a short inframammary scar. Plast Reconstr Surg69:45, 1982
Piexoto G: Reduction mammaplasty: A personal technique. Plast Reconstr Surg65:217, 1980
Piexoto G: Reduction mammaplasty. Aesth Plast Surg8:231, 1984
Ribeiro L: A new technique for reduction mammaplasty. Plast Reconstr Surg55:330, 1975
Robbins TH: A reduction mammaplasty with the areolarnipple based on an inferior dermal pedicle. Plast Reconstr Surg59:64, 1977
Toledo LS, Mastudo PKR: Mammaplasty using liposuction and the periareolar incision. Aesth Plast Surg13:9, 1989
Wise RJ: A preliminary report on a method of planning mammaplasty. Plast Reconstr Surg17:367, 1956
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Lee, T.J., Eom, J.S. Periareolar reduction mammaplasty utilizing the inferior dermal pedicle. Aesth. Plast. Surg. 23, 331–336 (1999). https://doi.org/10.1007/s002669900294
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DOI: https://doi.org/10.1007/s002669900294