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Reduction Mammaplasty for Breast Symmetrisation in Implant-Based Reconstructions

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

Abstract

Background

Healthy breast surgery constitutes an important step to achieve symmetry in unilateral implant-based reconstructions. We analysed long-term results of breast symmetry obtained with reduction mammaplasties, and we evaluated whether different glandular pedicles may better preserve long-term stability.

Method

Between 2006 and 2012, 90 patients underwent mastectomy and immediate reconstruction with tissue expanders and simultaneous contralateral reduction mammaplasty. In 30 patients, a superior nipple–areola pedicle was harvested (GROUP A), in another 30 patients a medial pedicle was performed (GROUP B), and an inferior pedicle was used in the remaining 30 women (GROUP C). An objective evaluation of the reconstructed breast and the reduced one was performed at 1 and 24 months after surgery. One-way ANOVA and Tukey’s HSD tests were used for analysis. Furthermore, three independent plastic surgeons filled out a questionnaire to assess aesthetic results.

Results

Measurements of the reconstructed breasts showed similar variations between 1- and 24-month evaluations within the three groups with no significant difference (P value >0.05). Measurements of the reduced breast at the 1- and 24-month follow-up (Tukey’s test) revealed significant differences among the three groups. Patients from GROUP C showed a significantly higher decrease in Δ nipple–lower clavicle margin distance and Δ nipple–inframammary fold compared to GROUP A and B (P value = 0.01). Surgeons’ assessments revealed no statistically significant difference between the three groups.

Conclusion

Superior or medial pedicle reduction mammaplasties seem to better preserve breast shape and position, and they maintain a more similar appearance to the contralateral prosthetic breast over time.

Level of Evidence IV

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Acknowledgements

All authors certify that they have NO affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationship, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. I sincerely thank Domenico Luca Grieco.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Breast Unit, University of Udine, C/o Ospedale “S. Maria Della Misericordia”, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy

    Fabrizio De Biasio, Nicola Zingaretti & Pier Camillo Parodi

  2. Department of Plastic and Reconstructive Surgery, European Institute of Oncology, Milan, Italy

    Francesca De Lorenzi

  3. Department of Reconstructive Plastic Surgery-Hand Surgery, Breast Unit, AOU “Ospedali Riuniti”, Ancona, Italy

    Michele Riccio

  4. Department of Plastic Surgery, IRCCS Policlinico San Donato, University of Milan, Milan, Italy

    Luca Vaienti

Authors
  1. Fabrizio De Biasio
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  2. Nicola Zingaretti
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  3. Francesca De Lorenzi
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  4. Michele Riccio
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  5. Luca Vaienti
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  6. Pier Camillo Parodi
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Corresponding author

Correspondence to Nicola Zingaretti.

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De Biasio, F., Zingaretti, N., De Lorenzi, F. et al. Reduction Mammaplasty for Breast Symmetrisation in Implant-Based Reconstructions. Aesth Plast Surg 41, 773–781 (2017). https://doi.org/10.1007/s00266-017-0867-2

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  • DOI: https://doi.org/10.1007/s00266-017-0867-2

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