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Long-Lasting Evolution of Ptosis Control After Reduction Mammaplasty Using the Hammock Technique

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Abstract

Background

The hammock technique combines inferior pedicle mammaplasty with retropectoral and inferior suspensions to prevent displacement of breast tissue toward the inferior mammarian pole. This study aimed to assess the long-lasting internal suspension with the author’s mammary reduction technique.

Methods

From 1987 to 2005, the hammock technique was performed for 623 breast reduction patients (1,201 breasts), including 318 women (636 breasts) who underwent the technique between 1994 and 2005. From the latter group, the author retrospectively reviewed the case histories of 281 patients who had come for long-term follow-up evaluation. All had significant ptosis associated with breast hypertrophy. Preoperative and postoperative examinations included evaluation of postoperative bottoming out by monitoring of three measurements: the sternal notch-to-nipple length, the inferior areolar border-to-inframammary fold length, and the distance between the inframmary fold and the projection of the lowest breast contour on the chest wall.

Results

The evaluation data on postoperative ptosis are derived from a control study at 30 months, 5 years, and 7 years or more for 281 women (562 breasts) of the 318 who underwent surgery using this technique over the 11-year period. Review after 2.5 to 7 years or more shows that inferior areolar border-inframammary fold distance increases no more than 10 mm.

Conclusions

The hammock technique suspension achieves true permanent breast lifting through dermis strips from the inferior pedicle itself. This procedure also gives predictable results, a low morbidity rate, and good breast shape.

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References

  1. Girard C: Uber Mastoptose und Mastopexie. Langenbecks Arch Klin Chir 92:829–842, 1910

    Google Scholar 

  2. Göbell R: Über Autoplastiche freie Fascien and Aponeurosentransplantation nach Martin Kirchner. Arch Klin Chir 146:478–480, 1927

    Google Scholar 

  3. Bames HO: Reduction of massive breast hypertrophy. Plast Reconstruct Surg 3:560–569, 1948

    Article  CAS  Google Scholar 

  4. Hanrahan EM: Mammaplasty: One-stage transposition operation. Plast Reconstr Surg 6:110–118, 1950

    Article  PubMed  CAS  Google Scholar 

  5. Maliniac JW: Evaluation of principal mammaplastic procedures. Plast Reconstr Surg 4:359–373, 1949

    Article  CAS  Google Scholar 

  6. Aufricut A: Mammaplasty for pendulous breasts: Empiric and geometric planning. Plast Reconstr Surg 4:13–29, 1949

    Article  Google Scholar 

  7. Erczy M: New method of mammaplasty by double wedge-shaped excision and submuscular suspension of the gland. Plast Reconstr Surg 16:374–386, 1955

    Article  PubMed  CAS  Google Scholar 

  8. Lewis GK: A method of mastopexy with fascia lata transplants. J Int Coll Surg 26:346–353, 1956

    PubMed  CAS  Google Scholar 

  9. Da Silva G: Mastopexy with dermal ribbon for supporting the breast and keeping it in shape. Plast Recontr Surg 34:403–405, 1964

    Article  Google Scholar 

  10. Hinderer UT: Plastia mamaria modelante de dermopexia superficial y retromamaria. Rev Esp Cir Plast 5:52–58, 1972

    Google Scholar 

  11. Garcia Padron J: Mammareduktionsplastik (Abstract): Transacta der III Tagung der Vereinigung der Deutschen, Plastischen, Chirurgen, pp. 85, 1972

  12. Figallo E: Surgical treatment of mammary ptosis without hypertrophy. Plast Reconstr Surg 60:189–196, 1977

    PubMed  CAS  Google Scholar 

  13. Johnson GW: Central core reduction mammaplasties and and Marlex suspension of breast tissue. Aesth Plast Surg 5:77–84, 1981

    Article  CAS  Google Scholar 

  14. De Longis E: Mammaplasty with an L-shaped limited scar and dermopexy. Aesth Plast Surg 10:171–175, 1986

    Article  CAS  Google Scholar 

  15. Perez-Macias JM: Reduction mammaplasty: The hammock technique. Abstracts of the Xth International ISAPS Congress, Zurich, pp. 144, 1989

  16. Svedman P: Correction of breast ptosis utilizing a “fold over” deepithelialized lower thoracic fasciocutaneous flap. Aesth Plast Surg 15:43–47, 1991

    Article  CAS  Google Scholar 

  17. Bustos RA: Periareolar mammaplasty with silicone supporting lamina. Plast Reconstr Surg 89:646–657, 1992

    Article  PubMed  CAS  Google Scholar 

  18. Rodrigo Cucalon MA: Mamoplastia tecnica “de la pelota.” Cir Plst Iberolatinoamer 18:147–165, 1992

    Google Scholar 

  19. Levet Y: Le pedicule posterior: Un concept anatomochirurgical de plastie mammaire. Ann Chir Plast Esthet 38:463–468, 1993

    PubMed  CAS  Google Scholar 

  20. Marconi F, Cavina C: Reduction mammaplasty and correction of ptosis: A personal technique. Plast Reconstr Surg 91:1046–1056, 1993

    Article  PubMed  CAS  Google Scholar 

  21. Goes JCS: Periareolar mammaplasty: Double skin technique with application of polyglactine or mixed mash. Plast Reconstr Surg 97:959–968, 1996

    Article  PubMed  CAS  Google Scholar 

  22. Cerqueira A: Mammoplasty: Breast fixation with dermoglandular mono upper pedicle flap under the pectoralis muscle. Aesth Plast Surg 22:276–283, 1998

    Article  Google Scholar 

  23. Frey MA: New technique of reduction mammaplasty: Dermis suspension and elimination of medial scars. Br J Plast Surg 52:45–51, 1999

    Article  PubMed  CAS  Google Scholar 

  24. Lockwood T: Reduction mammaplasty and mastopexy with superficial fascial system suspension. Plast Reconstr Surg 103:1411–1420, 1999

    Article  PubMed  CAS  Google Scholar 

  25. Quiau Q, Sun J, Liu C, Liu Z: Reduction mammaplasty and correction of ptosis: Dermal bra technique. Plast Reconstr Surg 111:1122–1130, 2003

    Article  Google Scholar 

  26. Baumeister RG: Curtain type combined pedicled reduction mammoplasty with internal suspension for extensive hypertrophic and ptotic breasts. Br J Plast Surg 56:114–119, 2003

    Article  PubMed  Google Scholar 

  27. De la Plaza R, de la Cruz L, Moreno C, Soto L: The crossed termal flaps technique for breast reduction. Aesth Plast Surg 28:383–392, 2004

    Article  CAS  Google Scholar 

  28. Widgerow AD: Breast reduction with inferior pedicle fascial suspension. Aesth Plast Surg 29:532–537, 2005

    Article  Google Scholar 

  29. Ritz M, Silfen R, Southwick G: Fascial suspension mastopexy. Plast Reconstr Surg 117:86–94, 2006

    Article  PubMed  CAS  Google Scholar 

  30. Graf R, Biggs TM: In search of better shape in mastopexy and reduction mammaplasty. Plast Reconstr Surg 110:309–317, 2002

    Article  PubMed  Google Scholar 

  31. Taubert E: Beitrag zur Mammaplastik. Zentralbl Chir 92(Suppl): 2011–2014, 1967

    PubMed  CAS  Google Scholar 

  32. Kohn F, Dalrymple J: Plastic reconstruction of the enlarged breast: Report of a new technique. Br J Plast Surg 20:184–198, 1967

    Article  PubMed  CAS  Google Scholar 

  33. Courtiss EH, Goldwyn RM: Reduction mammaplasty: The inferior pedicle technique. Plast Reconstr Surg 59:500– 507, 1977

    PubMed  CAS  Google Scholar 

  34. Kaplan I: Reduction mammaplasty: Nipple–areolar survival on single breast quadrant. Plast Reconst Surg 61:27–31, 1978

    Article  PubMed  CAS  Google Scholar 

  35. Reich J: The advantage of a lower central segment in reduction mammaplasty. Aesth Plast Surg 3:47–56, 1979

    Article  Google Scholar 

  36. Georgiade NC, Serafin D, Morris R, Georgiade G: Reduction mammaplasty utilizing an inferior pedicle nipple-areolar flap. Ann Plast Surg 3:211–218, 1979

    Article  PubMed  CAS  Google Scholar 

  37. Perez-Macias JM: Mamoplastia de reducción: Experiencia y estudio comparativo de la técnica del colgajo dermoglandular de pedículo inferior. Cir Plast Iberolatinoamer 9:27–36, 1985

    Google Scholar 

  38. Craig RD, Sykes PA: Nipple sensitivity following reduction mammaplasty. Br J Plast Surg 23:165–172, 1970

    Article  PubMed  CAS  Google Scholar 

  39. Gonzalez F, Brown FE, Gold ME, Walton RL, Shafer B: Preoperative and postoperative nipple–areola sensitivity in patients undergoing reduction mammaplasty. Plast Reconstr Surg 92:809–814, 1993

    PubMed  CAS  Google Scholar 

  40. Sarhadi NS, Shaw Dunn J, Lee FD, Soutar DS: An anatomical study of the nerve supply of breast, including the nipple and areola. Br J Plast Surg 49:156–164 41, 1996

    Google Scholar 

  41. Maliniac JW: Amputation versus transposition of gland and nipple in mammaplasty. Plast Reconstr Surg 3:37–51, 1948

    CAS  Google Scholar 

  42. Climo MS, Alexander JE: Intercostal circulation: Nipple survival in reduction mammaplasty in the absence of a dermal pedicle. Ann Plast Surg 4:128–132, 1980

    Article  PubMed  CAS  Google Scholar 

  43. Hester TR Jr, Bostwick J III, Miller L, Cunningham SJ: Breast reduction utilizing the maximally vascularised central breast pedicle. Plast Reconstr Surg 76:890–900, 1985

    Article  PubMed  Google Scholar 

  44. Van Deventer PV: The blood supply to the nipple–areola complex of the human mammary gland. Aesth Plast Surg 28:393–398, 2004

    Article  Google Scholar 

  45. Marshall DR Callan PP, Nicholson W: Breastfeeding after reduction mammaplasty. Br J Plast Surg 47:167–169, 1994

    Article  PubMed  CAS  Google Scholar 

  46. Bolger WE, Seyfer AE, Jackson SM: Reduction mammaplasty using the inferior glandular “pyramidal” pedicle: Experiences with 300 patients. Plast Reconstr Surg 80:75–84, 1987

    Article  PubMed  CAS  Google Scholar 

  47. Reus WF, Mathess SJ: Preservation of projection after reduction mammaplasty: Long-term follow-up of the inferior pedicle technique. Plast Reconstr Surg 82:644–652, 1988

    Article  PubMed  CAS  Google Scholar 

  48. Seyfer AE: Reduction mammaplasty using the inferior glandular pyramid pedicle. In: Georgiade NG (eds) Aesthetic surgery of the breast. WB Saunders: Philadelphia, pp. 363–370, 1990

    Google Scholar 

  49. Perez-Macias JM: Crossed-support hammock technique in mammarian reduction. Abstracts of the Xth Internatinal Congress of Plastic Reconstructive Surgery, Madrid. Excerpta Medica Plast Surg 2:609–610, 1992

    Google Scholar 

  50. Morgan JE: A sling operation using Marlex polypropylene mesh, for treatment of recent stress incontinence. Am J Obstet Gynecol 106:369–377, 1970

    PubMed  CAS  Google Scholar 

  51. Perez-Macias JM: Reduction mammoplasty with associated mastopexy: Hammock technique. Abstracts of the Transactions of the 11th Congress of the International Confederation for Plastic Reconstructive and Aesthetic Surgery, Yokohama, Japan. In: Harri K (ed) Excerpta medica. Kugler Publications BV, Amsterdam, New York, p. 130, 1995

    Google Scholar 

  52. Marc H: La plastie mammarie par la mèthode oblique. In: Doin G (ed) Paris. Rev Port Obstèt 5:363–373, 1952

  53. Mir Y Mir L: Nuestro criterio actual sobre la cirugia plastica de la hiprtrofia mamaria. Cir Plast Iberolatinoamer 1:135–146, 1975

    Google Scholar 

  54. Horibe K, Spina U, Lodivici O: Mamoplastia reductora: Nuevo abordaje del método lateral oblicuo. Rev Latino Am Cir Plast 2:7–12, 1956

    Google Scholar 

  55. Arie G: Una nueva tecnica de mastoplastia. Rev Latino Am Cir Plast 3:23, 1957

    Google Scholar 

  56. Elbaz JS, Verheecke G: La cicatrice en L dans les plasties mammaries. Ann Chir Plast 17:283–292, 1972

    PubMed  CAS  Google Scholar 

  57. Regnault P: Reduction mammaplasty by the B technique. Plast Reconstr Surg 53:19–24, 1974

    Article  PubMed  CAS  Google Scholar 

  58. Meyer R, Kesserling UK: Reduction mammaplasty with an L-shaped suture line. Plast Reconstr Surg 55:139–148, 1975

    Article  PubMed  CAS  Google Scholar 

  59. Marchac D, de Olarte G: Reduction mammaplasty and correction of ptosis with a short inframammary scar. Plast Reconstr Surg 69:45–55, 1982

    Article  PubMed  CAS  Google Scholar 

  60. Lassus C: An “al-season” mammoplasty. Aesth Plast Surg 10:9–15, 1986

    Article  CAS  Google Scholar 

  61. Chiari AC Jr: The L short-scar mammaplasty: A new approach. Plast Reconstr Surg 90:233–246, 1992

    Google Scholar 

  62. Rodriguez-Camps S: Mamaplastia de reduccion en “L”: Un nuevo camino. Cir Plast Iberolatinoamer 25:45–55, 1999

    Google Scholar 

  63. Perez-Macias JM: Dermis suspension in mammoplasty. Br J Plast Surg 52:421, 1999

    PubMed  CAS  Google Scholar 

  64. Perez-Macias JM: Personal mastopexy technique for breast stabilisation: Update. Br J Plast Surg 57:178, 2004

    Article  PubMed  Google Scholar 

  65. Moufarrage R: Dermoglandular pedicle mammoplasty. In: Georgiade NG (ed) Aesthetic surgery of the breast. WB Saunders: Philadelphia, pp. 371–386, 1990

    Google Scholar 

  66. Hinderer UT: Circumareolar dermo-glandular plication: A new concept for correction of breast ptosis. Aesth Plast Surg 25:404–420, 2001

    Article  CAS  Google Scholar 

  67. Mandrekas AD, Zambacos GJ, Anastasopoulos, et al. Reduction mammaplasty with the inferior pedicle technique: Early and late complications in 371 patients. Br J Plast Surg 49:442–446, 1996

  68. O´Grady KF, Thoma A, Dan Cin A: A comparison of complication rates in large and small inferior pedicle reduction mammaplasty. Plast Reconstr Surg 115:736–742, 2005

    Article  CAS  Google Scholar 

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  1. Pérez-Macías Plastic Surgery Clinic, García Morato 39 1-b, 47006, Valladolid, Spain

    José M. Pérez-Macías M.D.

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  1. José M. Pérez-Macías M.D.
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Correspondence to José M. Pérez-Macías M.D..

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Pérez-Macías, J.M. Long-Lasting Evolution of Ptosis Control After Reduction Mammaplasty Using the Hammock Technique. Aesth Plast Surg 31, 266–274 (2007). https://doi.org/10.1007/s00266-006-0188-3

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