Application of modified inferior pedicle technique with inverted T pattern for severe breast hypertrophy_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DUAN Weiqiang , CAO Chang , WU Junliang , CEN Ying ,  XU Xuewen ,  LIU Yong

Department of Aesthetic Plastic and Burn Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

XU Xuewen, Email: xxw_0826@163.com; LIU Yong, Email: liu.yong7088@163.com

Keywords：

Severe breast hypertrophy; breast reduction; inferior pedicle technique; dermal suspension sling technique

DOI：

10.7507/1002-1892.201811076

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the effectiveness of modified inferior pedicle technique with inverted T pattern for severe breast hypertrophy.Methods Between January 2016 and May 2017, 15 patients of severe breast hypertrophy had undergone breast reduction using inferior pedicle technique with inverted T pattern combined with dermal suspension sling technique. The patients were 20 to 49 years old, with an average age of 31.6 years. Body mass index ranged from 24.9 to 32.5 kg/m², with an average of 30.8 kg/m². Among them, 11 cases had a history of childbearing. The degree of breast ptosis was rated as degree Ⅱ in 6 cases and degree Ⅲ in 9 cases. The unilateral breast reduced 615 g on average (range, 480-1 050 g).Results The skin flap necrosis at the " T” trilateral junction occurred in 3 cases, and healed after dressing changes. The incisions of 12 cases healed and no fat liquefaction, hematoma, or seroma occurred. The sensation of nipple and areola declined at early period after operation in 2 cases, and gradually recovered. All patients were followed up 6-18 months (mean, 13 months). The shapes of bilateral breasts and the height and symmetry of nipple-areolar complex were good, and no obvious scar was found. The effectiveness was evaluated by surgeon and showed that there were 12 cases with satisfactory breast shape and 3 cases with unsatisfactory breast shape; 3 cases with obvious scare and 12 cases with insignificant scar; 13 cases with normal nipple sensation and 2 cases with hypoesthesia; 11 cases with symmetric nipples and 4 cases with asymmetric nipples. The effectiveness was evaluated by patients and showed that the satisfactory breast shape in 10 cases, relatively satisfactory breast shape in 4 cases, and unsatisfactory breast shape in 1 case; highly acceptable scar in 9 cases, moderately acceptable scar in 4 cases, and unacceptable scar in 2 cases; overall satisfactory in 10 cases, relatively satisfactory in 4 cases, and unsatisfactory in 1 case, with the overall satisfaction rate of 93.3% (14/15).Conclusion For severe breast hypertrophy, the modified inferior pedicle technique with inverted T pattern can obtain satisfactory appearance and avoid the mastoptosis.

Citation： DUAN Weiqiang, CAO Chang, WU Junliang, CEN Ying, XU Xuewen, LIU Yong. Application of modified inferior pedicle technique with inverted T pattern for severe breast hypertrophy. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(3): 341-344. doi: 10.7507/1002-1892.201811076 Copy

1.	王炜. 整形外科学. 杭州: 浙江科学技术出版社, 1999: 1143.
2.	Regnault P. Breast ptosis. Definition and treatment. Clin Plast Surg, 1976, 3(2): 193-203.
3.	Greco R, Noone B. Evidence-based medicine: reduction mammaplasty. Plast Reconstr Surg, 2017, 139(1): 230e-239e.
4.	Pitanguy I. Surgical treatment of breast hypertrophy. Br J Plast Surg, 1967, 20(1): 78-85.
5.	McKissock PK. Reduction mammaplasty with a vertical dermal flap. Plast Reconstr Surg, 1972, 49(3): 245-252.
6.	Robbins TH. A reduction mammoplasty with the areola-nipple based on an inferior dermal pedicle. Plast Reconstr Surg, 1977, 59(1): 64-67.
7.	Courtiss E, Goldwyn R. Reduction mammoplasty by the inferior pedicle technique. An alternative to free nipple and areola grafting for severe macromastia or extreme ptosis. Plast Reconstr Surg, 1977, 59(4): 500-507.
8.	Kelahmetoglu O, Firinciogullari R, Yagmur C, et al. Combination of Würinger’s horizontal septum and inferior pedicle techniques to increase nipple-areolar complex viability during breast reduction surgery. Aesthetic Plast Surg, 2017, 41(6): 1311-1317.
9.	Roje Z, Roje Z, Milosević M, et al. Current trends in breast reduction. Coll Antropol, 2012, 36(2): 657-668.
10.	Góes J, Landecker A, Lyra EC, et al. The application of mesh support in periareolar breast surgery: clinical and mammographic evaluation. Aesthet Plast Surg, 2004, 28(5): 268-274.
11.	Hidalgo DA, Elliot LF, Palumbo S, et al. Current trends in breast reduction. Plast Reconstr Surg, 1999, 104(3): 806-815.
12.	乔燕莎, 黄乃思, 武亚琼, 等. 非生物补片在乳房重建中的应用进展. 中国修复重建外科杂志, 2017, 31(9): 1141-1145.
13.	Alvo Z. Mammaplasty for mild and/or ptotic breast through short incision at the inframammary sulcus: a personal approach. Aesthet Plast Surg, 1997, 21(5): 352-355.
14.	Lockwood T. Reduction mammaplasty and mastopexy with superficial fascial system suspension. Ann Plast Surg, 1999, 103(5): 1411-1420.
15.	Lalardrie J, Jouglard J. Reduction mammaplasty: general approach and basic consideration. Aesthetic Plast Surg, 1982, 6(2): 81-83.
16.	Ding H, Wang B, Gu Y, et al. The combination of inferior pedicle method and dermal suspension sling technique: one new efficient method for breast reduction. Int J Clin Exp Med, 2015, 8(4): 6613-6620.
17.	Abozeid MF, Tahseen H, Kenawi I. McKissock’s reduction mammaplasty revisited: A case series study with 12-months follow-up. Plast Reconstr Surg, 2018, 6(6): e1791.
18.	Echo A, Guerra G, Yuksel E. The dermal suspension sling: shaping the inferior pedicle during breast reduction. Aesthetic Plast Surg, 2011, 35(4): 608-616.

1. 王炜. 整形外科学. 杭州: 浙江科学技术出版社, 1999: 1143.
2. Regnault P. Breast ptosis. Definition and treatment. Clin Plast Surg, 1976, 3(2): 193-203.
3. Greco R, Noone B. Evidence-based medicine: reduction mammaplasty. Plast Reconstr Surg, 2017, 139(1): 230e-239e.
4. Pitanguy I. Surgical treatment of breast hypertrophy. Br J Plast Surg, 1967, 20(1): 78-85.
5. McKissock PK. Reduction mammaplasty with a vertical dermal flap. Plast Reconstr Surg, 1972, 49(3): 245-252.
6. Robbins TH. A reduction mammoplasty with the areola-nipple based on an inferior dermal pedicle. Plast Reconstr Surg, 1977, 59(1): 64-67.
7. Courtiss E, Goldwyn R. Reduction mammoplasty by the inferior pedicle technique. An alternative to free nipple and areola grafting for severe macromastia or extreme ptosis. Plast Reconstr Surg, 1977, 59(4): 500-507.
8. Kelahmetoglu O, Firinciogullari R, Yagmur C, et al. Combination of Würinger’s horizontal septum and inferior pedicle techniques to increase nipple-areolar complex viability during breast reduction surgery. Aesthetic Plast Surg, 2017, 41(6): 1311-1317.
9. Roje Z, Roje Z, Milosević M, et al. Current trends in breast reduction. Coll Antropol, 2012, 36(2): 657-668.
10. Góes J, Landecker A, Lyra EC, et al. The application of mesh support in periareolar breast surgery: clinical and mammographic evaluation. Aesthet Plast Surg, 2004, 28(5): 268-274.
11. Hidalgo DA, Elliot LF, Palumbo S, et al. Current trends in breast reduction. Plast Reconstr Surg, 1999, 104(3): 806-815.
12. 乔燕莎, 黄乃思, 武亚琼, 等. 非生物补片在乳房重建中的应用进展. 中国修复重建外科杂志, 2017, 31(9): 1141-1145.
13. Alvo Z. Mammaplasty for mild and/or ptotic breast through short incision at the inframammary sulcus: a personal approach. Aesthet Plast Surg, 1997, 21(5): 352-355.
14. Lockwood T. Reduction mammaplasty and mastopexy with superficial fascial system suspension. Ann Plast Surg, 1999, 103(5): 1411-1420.
15. Lalardrie J, Jouglard J. Reduction mammaplasty: general approach and basic consideration. Aesthetic Plast Surg, 1982, 6(2): 81-83.
16. Ding H, Wang B, Gu Y, et al. The combination of inferior pedicle method and dermal suspension sling technique: one new efficient method for breast reduction. Int J Clin Exp Med, 2015, 8(4): 6613-6620.
17. Abozeid MF, Tahseen H, Kenawi I. McKissock’s reduction mammaplasty revisited: A case series study with 12-months follow-up. Plast Reconstr Surg, 2018, 6(6): e1791.
18. Echo A, Guerra G, Yuksel E. The dermal suspension sling: shaping the inferior pedicle during breast reduction. Aesthetic Plast Surg, 2011, 35(4): 608-616.

Chinese Journal of Reparative and Reconstructive Surgery

Application of modified inferior pedicle technique with inverted T pattern for severe breast hypertrophy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content