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Combination of Würinger’s Horizontal Septum and Inferior Pedicle Techniques to Increase Nipple-Areolar Complex Viability During Breast Reduction Surgery

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  • Breast Surgery
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Abstract

Background

Breast reduction techniques depend on the vascularity of the pedicle. Preserving vascularity of the nipple-areolar complex (NAC) is mandatory for reduction mammoplasties, as the NAC is the most important aesthetic and functional unit of the breast. The inferior pedicle technique is the most common method for breast reduction; however, pedicle length may increase after using this technique and cause problems related to NAC viability in gigantomastic and hypertrophic breasts. In this study, we present our technical approach to preserve NAC viability by combining Würinger’s horizontal septum and inferior pedicle techniques.

Methods

This study included 60 women (mean age 39.71 ± 10.52 years) who underwent a breast reduction combining Würinger’s horizontal septum and inferior pedicle procedures from April 2012 to January 2016. All patients were marked preoperatively in a standing upright position using a prefabricated Wise-pattern template. The base of the pedicle was marked at the level of the inframammary ridge at a width of 8 cm.

Results

The patients were followed up for a mean of 5.6 ± 3.3 months. The resection weights of the right and left sides were 1406 ± 566 and 1340 ± 563 g, respectively. Venous insufficiency was encountered in five cases (8.3%) and caused partial NAC necrosis in one case (1.6%). No cases of total NAC necrosis were encountered. Fifteen breasts (12.5%) were described as gigantomastic (resection weight >2000 g).

Conclusions

This combined method may promote safer and more satisfying outcomes from inferior pedicle breast reduction.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Authors and Affiliations

  1. Department of Plastic, Reconstructive and Aesthetic Surgery, Medical Faculty, Bezmialem Vakif University, Adnan Menderes Bulvarı, Fatih/Istanbul, Turkey

    Osman Kelahmetoglu, Kemalettin Yildiz & Ethem Guneren

  2. Department of Plastic, Reconstructive and Aesthetic Surgery, Ozel Ege Şehir Hastanesi, Izmir, Turkey

    Remzi Firinciogullari

  3. Department of Plastic, Reconstructive and Aesthetic Surgery, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey

    Caglayan Yagmur

Authors
  1. Osman Kelahmetoglu
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  2. Remzi Firinciogullari
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  3. Caglayan Yagmur
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  4. Kemalettin Yildiz
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  5. Ethem Guneren
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Correspondence to Osman Kelahmetoglu.

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Kelahmetoglu, O., Firinciogullari, R., Yagmur, C. et al. Combination of Würinger’s Horizontal Septum and Inferior Pedicle Techniques to Increase Nipple-Areolar Complex Viability During Breast Reduction Surgery. Aesth Plast Surg 41, 1311–1317 (2017). https://doi.org/10.1007/s00266-017-0933-9

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  • DOI: https://doi.org/10.1007/s00266-017-0933-9

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