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The Infero-Central Mound Reduction Mammoplasty: A Single Surgeon, 20-year Experience

  • Original Article
  • Breast Surgery
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Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Reduction mammoplasty (RM) remains one of the most common plastic surgeries worldwide. Many different techniques have been described in the literature, each with its advantages and limitations. Nipple-areolar complex necrosis remains a daunting complication, regardless of the chosen surgical approach.

Objective

We describe the senior author’s (HYK) unique reduction mammoplasty technique, employing the infero-central (IC) pedicle throughout the last two decades.

Patients and Methods

A retrospective chart review of 520 patients undergoing breast reduction was performed. After exclusion criteria, 360 were included in the study. These patients underwent RM with the IC technique, with stabilization of the breast mound and plication of the inferior pole dermis to prevent bottoming out. Demographics, operative data, and complications were recorded. Pre- and postoperative photographs were evaluated by a specialists’ panel. The BREAST-Q questionnaire was utilized to assess satisfaction rates.

Results

BREAST-Q questionnaire-satisfaction with breast score was 84.19, and outcome score was 91.67. Aesthetic outcome evaluation, reviewed by four plastic surgeons, yielded a high score in all parameters (1.64–2; range 0–2). On a per-breast basis for all patients, the following complications were analyzed: dehiscence (3.61%), infection (2.22%), hematoma (1.66%), superficial wound healing problems (1.38%), seroma (0.83%), skin flap ischemia (1.52%), hypertrophic scar (1.38%), fat necrosis (0.97%), and partial nipple ischemia (0.27%).

Conclusion

Infero-central mound technique can be applied to breast reductions of nearly all sizes, allowing for consistently satisfactory aesthetic outcomes for most patients. Due to robust vascularity of the pedicle, complication rates are kept at a minimum. IC mound technique is an essential tool in the plastic surgeon’s armamentarium.

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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Funding

This study has no funding. No funding was received for this work from any of the following organizations: National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); RCUK; and other(s). Dr. Kaplan has nothing to disclose. No funding was received for this article. Dr. Shachar has nothing to disclose. No funding was received for this article. Dr. Rysin has nothing to disclose. No funding was received for this article. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

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Authors and Affiliations

  1. Department of Plastic Surgery, Yitzhak Shamir Medical Center, 70300, Tzrifin, Israel

    Haim Yoel Kaplan

  2. Private clinic, 10 Dubnov street, 6473209, Tel Aviv, Israel

    Haim Yoel Kaplan, Roman Rysin & Yair Shachar

Authors
  1. Haim Yoel Kaplan
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  2. Roman Rysin
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Contributions

HK provided substantial contributions to: 1) conception and design, acquisition of data, analysis, and interpretation of data; 2) drafting the article; 3) final approval of the version to be published; 4) agreement to be accountable for all aspects of the work. RR substantially contributed to: 1) conception and design, acquisition of data, analysis, and interpretation of data; 2) drafting the article; 3) final approval of the version to be published; 4) agreement to be accountable for all aspects of the work. YS provided substantial contributions to: 1) conception and design, acquisition of data, analysis and interpretation of data; 2) drafting the article; 3) final approval of the version to be published; 4) agreement to be accountable for all aspects of the work.

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Correspondence to Haim Yoel Kaplan.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Supplementary Information

Below is the link to the electronic supplementary material.

Video 1 Initial flap dissection (MP4 22299 KB)

Video 2 Flap elevation (MP4 41610 KB)

Video 3 Flap undermining (MP4 3818 KB)

Video 4 Breast mound resection (MP4 58176 KB)

Video 5 Inferior pedicle measurement (MP4 5969 KB)

Video 6 Inferior pedicle plication (MP4 11143 KB)

Video 7 Superior pole fixation suture (MOV 29248 KB)

Video 8 Flap re-draping (MP4 9339 KB)

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Kaplan, H.Y., Rysin, R. & Shachar, Y. The Infero-Central Mound Reduction Mammoplasty: A Single Surgeon, 20-year Experience. Aesth Plast Surg 48, 914–924 (2024). https://doi.org/10.1007/s00266-023-03442-8

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