Choosing a Technique in Breast Reduction
The perfect procedure to reduce the breast has been sought for centuries. Kraske , modifying the technique of Lexer , suggested an inverted Thpattern consisting of an inferior vertical wedge glandular excision and a vertical and transverse ellipse of skin. However, lack of understanding of the blood supply to the nipple– areola complex (NAC) led to erratic results, and there was a time when a two-stage procedure was advocated.
Schwarzmann, in 1930 , advanced the concept of a dermal pedicle using a superior and medial dermal cutaneous pedicle bridge to the NAC. This improved the safety of the procedure. The search for a reproducible design led Wise  to modify the pattern of Nedhoff, which led to the keyhole markings. Wise used a full thickness graffor the NAC.
KeywordsBreast Reduction Inframammary Fold Inferior Pedicle Vertical Limb Skin Retraction
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