Liposuction and Superior Pedicle

  • Felix Giebler
  • Eva Giebler

Most of the vascularization of the breast comes from superiorly the lateral thoracic artery, from the perforators of the internal mammary, and from the intercostal perforators three to six [1, 2]. The nipple—areolar complex (NAC) is perfused by superficial dermal vessels [3] that are important for cosmetic procedures and deepithelial-ization. The lymphatic drainage of the breast is established by the axillary lymph nodes and the parasternal (inter-thoracic) primary lymph nodes.

The vascularization and the innervation (from the superior portion of the supra clavicle nerves and from the third to fifth branches of the clavicle plexus) are highly important for the formation and the function of a flap or pedicle [4]. A cosmetic procedure on the breast should not interfere with the sensitivity or the vascularization of the NAC, in order to not hamper its function and its erotic function, too. Whichever technique is used, it is important to preserve the nipple sensation [5].


Primary Lymph Node Cosmetic Procedure Vertical Scar Lateral Pillar Superior Pedicle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Edwards E: Surgical anatomy of the breast. In: Goldwyn RM (ed). Plastic and Reconstructive Surgery of the Breast. Boston, Little Brown 1976Google Scholar
  2. 2.
    Rohen JW: Topographische Anatomie. Stuttgart, Schattauer 1971, pp 95–99Google Scholar
  3. 3.
    Mitz V, Lassau JP: Etude des rapports entre les vascularisa-tions arterielles glandulaires et cutanees du sein. Arch Anat Path 1973;21(4):365–374Google Scholar
  4. 4.
    Maliniac JW: Arterial blood supply of the breast: revised anatomic data relating to reconstructive surgery. Arch Surg 1043;47:329Google Scholar
  5. 5.
    Wuringer E, Mader N, Posch E, Holle J: Nerve and vessel supplying ligamentous suspension of the mammary gland. Plast Reconstr Surg 1988;101(6):1486–1493Google Scholar
  6. 6.
    Lexer E: Hypertrophie beider mammae. Munch Med Wochenschr 1912;59:2702Google Scholar
  7. 7.
    Kraske H: Die operation der atrohischen und hypertro-phischen hangbrust. Munch Med Wochenschr 1923;60:672–673Google Scholar
  8. 8.
    Pitanguy I: Une nouvelle technique mammaire. Etude de 245 cas consecutifs et presentation d'une technique perso-nelle. Ann Chir Plast 1962;7:199–208PubMedGoogle Scholar
  9. 9.
    Strombeck JO: Mammaplasty: report of a new technique based on the two pedicle procedure. Br J Plast Surg 1960; 13:79–90CrossRefPubMedGoogle Scholar
  10. 10.
    Lassus C: Breast reduction: evaluation of a technique — a single vertical scar. Plast Reconstr Surg 1995;3:189–198Google Scholar
  11. 11.
    Lejour M: Vertical mammaplasty for breast hypertrophy and ptosis. Operative technique. Plast Reconstr Surg 1996;3:189–198Google Scholar
  12. 12.
    Hohler H: Die reduktionsplastik der weiblichen brust. Zeitschrift Plast Chir 1978;2:68–91Google Scholar
  13. 13.
    Lejour M: Vertical mammaplasty and liposuction of the breast. Plast Reconstr Surg 1994;94(1):100–114CrossRefPubMedGoogle Scholar
  14. 14.
    Teimourian B, Massac E, Wiegering CE: Reduction suction mammoplasty and suction lipectomy as an adjunct to breast surgery. Reduction suction mammoplasty and suction lipectomy as an adjunct to breast surgery. Aesthetic Plast Surg 1985;9(2):97–100CrossRefPubMedGoogle Scholar
  15. 15.
    Zocchi M: Ultrasonic liposculpturing. Aesthetic Plast Surg 1992;16(4):287–298CrossRefPubMedGoogle Scholar
  16. 16.
    Klein JA: The tumescent technique for liposuction surgery. Am J Cosm Surg 1987;4:2163–267Google Scholar
  17. 17.
    Skoog T: A technique of breast reduction — transposition of the nipple on a cutaneous vascular pedicle. Acta Chir Scand 1963;126:453–465PubMedGoogle Scholar
  18. 18.
    Giebler FRG: Vertikale reduktionsplatik. Aesth Trib, Wiesbaden 2006;7:15Google Scholar
  19. 19.
    Hamdi M, Greuse M, Nemec E, Deprez C, DeMay A: Breast sensation after superior pedicle versus inferior pedicle mammaplasty: anatomical and histological evaluation. Br J Plast Surg 2001;54(1):43–46CrossRefPubMedGoogle Scholar
  20. 20.
    Craig RD, Sykes PA: Nipple sensitivity following reduction mammaplasty. Br J Plast Surg 1970;23(2):167–172Google Scholar
  21. 21.
    Toledo LS, Matsudo PKR: Mammoplasty using liposuction and the periareolar incision. Aesthetic Plast Surg 1989; 13(1):9–13CrossRefPubMedGoogle Scholar
  22. 22.
    Schlenz I, Kuzbari R, Gruber H, Holle J: The sensitivity of the nipple-areola complex: an anatomic study. Plast Reconstr Surg 2000;105(3):905–909CrossRefPubMedGoogle Scholar
  23. 23.
    Hinderer UT: Mammaplasty techniques in the treatment if the ptotic breast with hypertrophy, of average size, or with hypoplasia. In Zaoli G (ed). Advances in Aesthetic Plastic Surgery. Padova, Piccin Nuova Libraria 2001, pp 409–450Google Scholar
  24. 24.
    Lewis JR Jr: Reduction mammaplasty. Borrowing the good points of many techniques. Aesthetic Plast Surg 1976;1:43–55CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Felix Giebler
    • 1
  • Eva Giebler
    • 1
  1. 1.Vincemus-Klinik, Brückenstraße 1aFriedrichstadt/EiderGermany

Personalised recommendations