Skip to main content

Advertisement

SpringerLink
Log in

Thin Superior Medial Pedicle Reduction Mammaplasty for Severe Mammary Hypertrophy

  • Original Article
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

There are multitudes of procedures in plastic surgery used to correct hypertrophic and pendulous breasts in patients with heavy and ptotic breasts who need great resections of breast tissue, where the suprasternal notch-to-nipple distance is long and the use of nipple-areola transposition techniques is a challenge for the plastic surgeon. The purpose of this study is to present a technique of reduction mammaplasty that could solve these problems based on the following principles: mammary reduction utilizing a thin superior medial pedicle (0.8–1.5 cm thick) and the resection performed in two steps: (1) the base excess at a plane perpendicular to the breast (this determines the cone’s height) and (2) central half keel (this determines the breast diameter reduction).

Methods

Ninety patients with mammary hypertrophy were operated on at the “Hospital das Clínicas,” São Paulo University Medical School, between January 2000 and November 2005. Inclusion in this study required a minimum of 12-cm change in nipple position and a 750-g breast resection.

Results

The mean change in nipple position was 16 cm (range = 12–21 cm). The mean weight of each breast was 1400 (range = 750–3000 g).Considering the great amount of volume removed and the size of the operated breasts, few complications were observed and were similar to those reported following other techniques described in the literature. Patient satisfaction following this procedure was high.

Conclusion

The results of this study clearly demonstrate that thin superior medial pedicle reduction mammaplasty is a safe and reliable technique in cases of severe mammary hypertrophy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20

Similar content being viewed by others

References

  1. Bames HO (1948) Reduction of massive breast hypertrophy. Plast Reconstr Surg 3:560

    Article  CAS  Google Scholar 

  2. Baroudi R, Lewis JR (1976) The augmentation-reduction mammaplasty. Clin Plast Surg 3:301–308

    PubMed  CAS  Google Scholar 

  3. Biesenberger H (1931) Deformitaten und Hosmetishe Operationen der weiblichen Brust. Maudrich, Vienna

    Google Scholar 

  4. Born G (1994) The “L” reduction mammoplasty. Ann Plast Surg 32:383–387

    Article  PubMed  CAS  Google Scholar 

  5. Bustos R (1988) Mamaplastia periareolar. Communications of the XXVth Brazilian congress of plastic surgery, Salvador, Brazil

    Google Scholar 

  6. Brauman D (1994) Reduction mammaplasty by suction alone. Plast Reconstr Surg 94:1095–1096

    Article  PubMed  CAS  Google Scholar 

  7. Chiari A Jr (2001) The L short-scar mammaplasty: 12 years later. Plast Reconstr Surg 108(2):489–495

    Article  PubMed  Google Scholar 

  8. Chiari A Jr (2002) The L short-scar mammaplasty. Clin Plast Surg 29(3):401–409

    Article  PubMed  Google Scholar 

  9. Conway H (1952) Mammaplasty: analysis of 110 consecutive cases with end results. Plast Reconstr Surg 10:303–315

    Article  CAS  Google Scholar 

  10. Courtiss EH (1993) Reduction mammaplasty by suction alone. Plast Reconstr Surg 92:1276–1284; discussion 1285–1289

    PubMed  CAS  Google Scholar 

  11. Courtiss EH, Goldwym RM (1977) Reduction mammaplasty by the inferior pedicle technique. An alternative to free nipple and areola grafting for severe macromastia or extreme ptosis. Plast Reconstr Surg 59:500–507

    PubMed  CAS  Google Scholar 

  12. Costa MP, Tuma P, Ferreira MC (2005) Reduction mammaplasty with resection of a trapezoid base prism and adduction of the arms. Plast Reconstr Surg 116(1):242–250

    Article  PubMed  CAS  Google Scholar 

  13. Dartigues L (1935) Les anomalies du sein en dehors des hypertrophies et des prolapsus. Bull Mem Soc Méd Paris 139:575

    Google Scholar 

  14. de Benito J, Sanza IF (1993) Periareolar techniques for mammary reduction and elevation. Aesthetic Plast Surg 17:311–316

    Article  PubMed  Google Scholar 

  15. de Castro CC (1976) Mammaplasty with curved incisions. Plast Reconstr Surg 57:596–600

    Article  PubMed  Google Scholar 

  16. Dufourmentel L (1939) Chirurgie reparatrice et correctrice des téguments et des formes. Masson, Paris

    Google Scholar 

  17. Farina R, Villano JB (1972) Reduction mammaplasty with free grafting of the nipple and areola. Br J Plast Surg 25:393–398

    Article  PubMed  CAS  Google Scholar 

  18. Ferreira MC, Ishida J, Gemperli R, Monteiro AA Jr, Tuma PT Jr (1995) Reduction mammoplasty with shortened scars: surgical technique. Rev Hosp Clin Fac Med São Paulo 50 Suppl:22–24 (in Portuguese)

    Google Scholar 

  19. Gillies H, McIndoe AH (1939) The technique of mammaplasty in conditions of hypertrophy of the breast. Surg Gynecol Obstet 68:658

    Google Scholar 

  20. Hall-Findlay EJ (2002) Pedicles in vertical breast reduction and mastopexy. Clin Plast Surg 29(3):379–391

    Article  PubMed  Google Scholar 

  21. Hall-Findlay EJ (1999) A simplified vertical reduction mammaplasty: shortening the learning curve. Plast Reconstr Surg 104(3):748–759

    Article  PubMed  CAS  Google Scholar 

  22. Johnson CF (1976) New technique for reduction mammaplasty. Plast Reconstr Surg 57:372

    Article  PubMed  CAS  Google Scholar 

  23. Shin KS, Chung S, Lee HK, Lew JD (1996) Reduction mammaplasty by central pedicle with short submammary scar. Aesthetic Plast Surg 20:69–76

    Article  PubMed  CAS  Google Scholar 

  24. Koger KE, Sunde D, Press BH, Hovey LM (1994) Reduction mammaplasty for gigantomastia using inferiorly based pedicle and free nipple transplantation. Ann Plast Surg 33:561–564

    Article  PubMed  CAS  Google Scholar 

  25. Lassus C (1996) A 30-year experience with vertical mammaplasty. Plast Reconstr Surg 97:373–380

    Article  PubMed  CAS  Google Scholar 

  26. Lejour M (1994) Vertical mammaplasty and liposuction of the breast. Plast Reconstr Surg 94:100–114

    Article  PubMed  CAS  Google Scholar 

  27. May H (1956) Breast plasty in the female. Plast reconstr surg (1946) 17:351–357

    CAS  Google Scholar 

  28. McKissock PK (1972) Reduction mammaplasty with a vertical dermal flap. Plast Reconstr Surg 49:245–252

    Article  PubMed  CAS  Google Scholar 

  29. Meijer R (1974) A modified Aufricht reduction mammaplasty. Plast Reconstr Surg 53:129–132

    Article  PubMed  CAS  Google Scholar 

  30. Meyer R, Kesselring UR (1975) Reduction mammaplasty with an L-shaped suture line. Development of different techniques. Plast Reconstr Surg 55:139–148

    CAS  Google Scholar 

  31. Orlando JC, Guthrie RH Jr (1975) The superomedial dermal pedicle for nipple transposition. Br J Plast Surg 28:42–45

    PubMed  CAS  Google Scholar 

  32. Pandeya NK (1995) Another technique for reduction mammaplasty. Plast Reconstr Surg 95:774

    Article  PubMed  CAS  Google Scholar 

  33. Peixoto G (1980) Reduction mammaplasty: a personal technique. Plast Reconstr Surg 65:217–226

    PubMed  CAS  Google Scholar 

  34. Penn J (1955) Breast reduction. Br J Plast Surg 7:357–371

    Article  PubMed  CAS  Google Scholar 

  35. Pontes R (1973) A technique of reduction mammaplasty. Br J Plast Surg 26:365–370

    PubMed  CAS  Google Scholar 

  36. Pitanguy I (1969) Breast hypertrophy. In: Transactions of the international society of plastic surgeons, second congress, London. Edinburgh: Livingstone, p 509

  37. Regnault P (1974) Reduction mammaplasty by the “B” technique. Plast Reconstr Surg 53:19–24

    Article  PubMed  CAS  Google Scholar 

  38. Ribeiro L (1975) A new technique for reduction mammaplasty. Plast Reconstr Surg 55:330–334

    Article  PubMed  CAS  Google Scholar 

  39. Robbins TH (1977) A reduction mammaplasty with the areola-nipple based on a inferior dermal pedicle. Plast Reconstr Surg 59:64–67

    Article  PubMed  CAS  Google Scholar 

  40. Góes JC (1996) Periareolar mammaplasty: double skin technique with application of poliglactine or mixed mesh. Plast Reconstr Surg 97:959–968

    Article  PubMed  Google Scholar 

  41. Schatten WE, Hartley JH Jr, Hamm WG (1971) Reduction mammaplasty by the Dufourmentel-Mouly method. Plast Reconstr Surg 48:306–310

    Article  PubMed  CAS  Google Scholar 

  42. Scutari M, Varotto S (1996) A nest swallow’s technique in reduction mastoplasty and mastopexy. Acta Chir Ital 52:169

    Google Scholar 

  43. Skoog T (1963) A technique of breast reduction: transposition of the nipple on a cutaneous vascular pedicle. Acta Chir Scand 126:453–465

    PubMed  CAS  Google Scholar 

  44. Stombeck JO (1971) Reduction mammaplasty. Surg Clin North Am 51:453–469

    Google Scholar 

  45. Strömbeck JO (1960) Mammaplasty: report of a new technique based on two-pedicle procedure. Br J Plast Surg 13:79–90

    Article  PubMed  Google Scholar 

  46. Thorek M (1942) Plastic surgery of the breast and the abdominal wall. Thomas, Springfield, IL

    Google Scholar 

  47. Hawtof DB, Levine M, Kapetanski DI, Pieper D (1989) Complications of reduction mammaplasty: comparison of nipple-areolar graft and pedicle. Ann Plast Surg 23:3–10

    Article  PubMed  CAS  Google Scholar 

  48. Melega JM, Zanini SA, Psillakis JM (1992) Cirurgia Plástica Reparadora e Estética 2a Edição Edit. Medsi. MEDSI Editora Médica e Científica LTDA, Rio de Janeiro/Brazil, pp 707–724

  49. Rees TD (1971) An historical review of mammaplasty. Transactions of the fifth international congress of plastic and reconstructive surgery, Australia. Butterworths, London, pp 1167–1173

    Google Scholar 

  50. Rees TD, LaTrenta GS (1994) Aesthetic plastic surgery, 2nd edn, vol II. W. B. Saunders Company, Philadelphia, PA, pp 925–1002

Download references

Author information

Authors and Affiliations

  1. Hospital das Clínicas, University of São Paulo, Sao Paulo, SP, Brazil

    Márcio Paulino Costa

  2. Rua Gabriel dos Santos, 759 12° andar, Santa Cecília, Sao Paulo, SP, 01231-011, Brazil

    Márcio Paulino Costa

  3. Hospital do Servidor Público Estadual, Sao Paulo, Brazil

    An Wan Ching

  4. São Paulo University Medical School, Sao Paulo, Brazil

    Marcus Castro Ferreira

Authors
  1. Márcio Paulino Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. An Wan Ching
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marcus Castro Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Márcio Paulino Costa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Costa, M.P., Ching, A.W. & Ferreira, M.C. Thin Superior Medial Pedicle Reduction Mammaplasty for Severe Mammary Hypertrophy. Aesth Plast Surg 32, 645–652 (2008). https://doi.org/10.1007/s00266-008-9163-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-008-9163-5

Keywords

Search

Navigation