Application of three-dimensional scanning technology in evaluating breast symmetry in reduction mammaplasty / 中华医学美学美容杂志

Objective:To evaluate the aesthetic results of bilateral breast symmetry after reduction mammaplasty, we proposed a handheld 3D scanner-based evaluation method to achieve the desired aesthetic effects.Methods:From June 2018 to June 2019, a total of 56 female patients with an average age of 34 years (18 to 56 years) requested for bilateral breast reduction in the Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Three-dimensional scans were performed intraoperatively in 27 cases in study group, and symmetry adjustments were made during breast contouring based on the analysis results; in the control group, a total of 29 patients did not undergo three-dimensional scans intraoperatively. Three-dimensional scans were obtained from both groups 3 months after surgery to objectively assess breast symmetry. Six third-party physicians scored the two groups based on anonymous photographs of the patients in 5 dimensions of breast symmetry to assess the symmetry of the pre- and post-operative bilateral breasts.Results:The difference in breast volume in the study group was significantly smaller bilaterally than in the control group [35.26 (20.01, 55.61) vs 110.02 (43.52, 186.30) cm 3,U=221.00, P=0.001]. The results reported by the evaluators showed that all five aspects of breast symmetry measured by breast reduction were significantly improved in the study group compared to the preoperative period ( P<0.001) and were all statistically superior to the control group ( P<0.05). Conclusions:Intraoperative three-dimensional scanning technology presents a dependable method to facilitate in optimizing bilateral breast symmetry, which in turn provides an opportunity to enhance the aesthetic outcome after reduction mammoplasty.

Application of liposuction technique assisted superomedial pedicle with vertical incision in reduction mammaplasty / 中国修复重建外科杂志

Objective: To explore the effectiveness of liposuction technique assisted superomedial pedicle with a vertical incision in reduction mammaplasty. Methods: Between March 2014 and March 2019, 65 patients (127 sides) with breast hypertrophy had undergone breast reduction by using liposuction technique assisted superomedial pedicle with a vertical incision. The patients were 21 to 58 years old, with an average of 42.2 years. Body mass index ranged from 18.8 to 26.5 kg/m 2, with an average of 21.3 kg/m 2. Among them, 62 cases were bilateral operations and 3 cases were unilateral operation. The degree of mastoptosis was rated as degreeⅡ in 73 sides and degree Ⅲ in 54 sides according to the Regnault criteria. Results: The unilateral breast removed 432 g on average (range, 228-932 g); the distance of nipple upward was 4.5-9.5 cm (mean, 6.5 cm); the volume of unilateral liposuction was 50-380 mL (mean, 148 mL). There were 2 sides (1.58%) of unilateral intramammary hematomas after operation, 4 sides (3.15%) of bilateral breast vertical incisions slightly split, and 1 side (0.79%) of the nipple-areola epidermis necrosis. All patients were followed up 6 months to 5 years, with an average of 18 months. During the follow-up, there was no evident re-dropping of the breast and no enlargement of the areola. No patient underwent scar excision. At last follow-up, the effectiveness was evaluated by the surgeons. There were 52 cases with very satisfactory, 10 cases with satisfactory, and 3 cases with unsatisfactory for the breast shape and symmetry. There were 51 cases with very satisfactory, 11 cases with satisfactory, and 3 cases with unsatisfactory for the nipple position and areola diameter. The incision scar was obvious in 25 cases and was not obvious in 40 cases. The results of self-assessment showed very satisfactory for the breast shape in 48 cases, satisfactory in 12 cases, and unsatisfactory in 5 cases; very satisfactory for the incision scar in 40 cases, satisfactory in 17 cases, and unsatisfactory in 8 cases. Overall evaluation of the patient was very satisfactory in 52 cases, satisfactory in 7 cases, and unsatisfactory in 6 cases. Conclusion: The liposuction technique assisted superomedial pedicle with a vertical incision in reduction mammaplasty is a safe and reliable surgical method with a satisfactory result.

Aplicação estética e reconstrutora da mamoplastia com pedículo areolado / Aesthetic and reconstructive application of mammoplasty with the inferior dermal pedicle technique

Introdução: A mamoplastia redutora é uma das mais frequentes cirurgias realizadas no âmbito da cirurgia plástica, sendo que diversas técnicas são descritas. A técnica do pedículo inferior areolado é uma técnica pouco difundida no Brasil, que pode ter aplicação tanto em cirurgias estéticas quanto reconstrutoras. O objetivo deste estudo foi analisar os resultados de mamoplastias realizadas com esta técnica. Métodos: Análise retrospectiva de prontuários, contato telefônico com as pacientes e análise fotográfica, identificando perfil das pacientes, finalidade da cirurgia, complicações, grau de satisfação e grau de sensibilidade do complexo aréolo-papilar (CAP). Resultados: No período analisado, 74 pacientes foram submetidas à mamoplastia com a técnica do pedículo inferior areolado (42 mamoplastias redutoras estéticas, 13 mamoplastias para reconstrução imediata de mama pós-ressecções segmentares, e 19 mamoplastias de simetrização pós-reconstrução com outras técnicas). Complicações ocorreram em 20 pacientes. Em relação à avaliação da satisfação pelas pacientes, o resultado foi considerado ótimo em 62,16% dos casos, bom em 25,67%, e regular em 12,17%. Quanto à sensibilidade do CAP, 72,97% das pacientes referiram não haver perda da sensibilidade, 20,27% referiram pequena diminuição, 6,76% referiram diminuição significativa e nenhuma relatou perda total da sensibilidade. Conclusões: A técnica de mamoplastia redutora com pedículo inferior areolado apresenta boa aplicabilidade, tanto em cirurgias estéticas quanto reconstrutoras, seja em reconstruções imediatas (quadrantectomias superiores) ou em simetrizações, principalmente pós TRAM. Apresenta alto grau de satisfação com o resultado, baixa taxa de complicações, alta preservação da sensibilidade do CAP e boa manutenção do resultado.

Introduction: Reduction mammaplasty is one of the most common surgeries performed in the field of plastic surgery, and several techniques have been described. The inferior dermal pedicle technique, which is relatively unknown in Brazil, may have applications in both aesthetic and reconstructive surgery. The aim of the current study was to analyze the results of mammaplasty performed with this technique. Methods: Data were collected from a retrospective analysis of medical records. Study data also included data obtained through telephone contact with patients, photographic analysis, and patient profiles, as well as data on the purpose of the surgery, complications, satisfaction with results, and degree of sensitivity of the nipple-areolar complex (NAC). Results: During the study period, 74 patients underwent mammaplasty with the inferior pedicle technique (42 aesthetic reduction mammaplasties, 13 mammaplasties for immediate breast reconstruction following segmental resections, and 19 post-reconstruction symmetrization mammaplasties with other techniques). Complications occurred in 20 patients. Regarding the assessment of satisfaction by the patients, the outcome was rated as excellent in 62.16% of cases, good in 25.67%, and fair in 12.17%. In terms of the sensitivity of the NAC, 72.97% of patients reported no loss of sensitivity, 20.27% reported a small loss, 6.76% reported significant loss, and no patients reported a total loss of sensitivity. Conclusions: The inferior pedicle reduction mammaplasty technique has good applicability both in aesthetic reconstructive surgeries and in immediate reconstructions (upper quadrantectomies) or symmetrizations, especially after the use of a transverse rectus abdominis myocutaneous flap. The technique offers a high degree of satisfaction with the results, a low rate of complications, a high degree of preservation of the sensitivity of the NAC, and good maintenance of the results.

Clinical application of vertical incision pasty of breast / 中国基层医药

Objective To investigate the clinical effect of vertical incision for breast surgery.Methods According to Lejour method,the first breast shape on the patients who needed operation was designed,and make a mark line corresponding to the breast,and then removal of excess tissue during the operation,operation process should pay attention to the protection of important part of breast of vessels and nerves,to prevent the impact of breast lactation function.Results The operation in 48 patients with breast because of too much too small in patients with 2 cases,1 cases of patients areola was too large,the patients were followed up survey,all the patients were satisfied with the operation of the breast shape,1 cases of operation the scar not satisfied,then the operation scar resection of operation after further results were satisfied,the total satisfaction rate was 98%.Conclusion Breast reconstruction process using vertical incision method for patients with relatively small,less bleeding,almost did not affect the normal function of patients with breast,breast shape is preferred for patients with operation scheme.

Vertical incision scar reduction mammaplasty with medial-superior pedicle based on Würinger's horizontal septum / 中华医学美学美容杂志

Objective The vertical mammaplasty improves the breast morphology,and reduces the operative scar.However,the nipple-and-areola complex (NAC) has the risk of necrosis on those severe patients.In this report,we performed the vertical incision scar reduction mammaplasty based on Würinger's horizontal septum to reduce the NAC necrosis possibility.Methods Typical Lejour mosque-dome design was performed.The inferior part of glandular tissue and skin were excised.The NAC was elevated to normal position with medial-superior pedicle based on the horizontal septum.The breast morphology was modified with lateral and medial glandular pillar suturing using nonabsorbent thread.For reducing the vertical scar,the lower breast flap was thinned to induce the skin contraction.Results 27 patients with breast hypertrophy were operated from May 2009 to October 2012.1 patient had unilateral breast reduction,and 6 patients with 8 breasts had partial wound dehiscence.They were treated conservatively with topical dressings.No complete NAC necrosis occurred.Conclusions The vertical reduction mammaplasty based on Würinger's horizontal septum is a safe and effective approach,and the NAC necrosis possibility is reduced with this procedure.

Mamoplastia redutora pela técnica de pedículo inferior: estudo descritivo / Brest reduction with the lower pedicle technique: an observational study

INTRODUÇÃO: A mamoplastia redutora utilizando pedículo inferior incluindo complexo aréolopapilar é muito utilizada na América do Norte, mas pouco difundida no Brasil. Sua principal vantagem é a utilização em grandes ptoses mamárias, mantendo a sensibilidade da aréola. OBJETIVO: O objetivo é descrever as características pré e pós-operatórias de pacientes submetidos a mamoplastia redutora pela técnica do pedículo inferior areolado na Santa Casa de Campo Grande - MS em 2013. MÉTODO: Entrevista, exame físico e dados de prontuário das pacientes operadas por esta técnica nessa instituição no ano de 2013. RESULTADOS: Foram avaliadas 40 pacientes, sendo que a idade variou de 21 a 68 anos, com média de 40,62 anos. As comorbidades relatadas foram hipertensão arterial sistêmica, diabetes, retocolite ulcerativa, hérnia de disco e distúrbio de ansiedade. O peso médio de tecido mamário ressecado foi 600,6g na mama direita e 609,6g na mama esquerda. Dentre as queixas pré-operatória, a mais comum foi a lombalgia, seguida por dor nos ombros. As mais frequentes complicações no pós-operatório recente foram a deiscência do ponto médio da vertente (10%) e o hematoma (5%).O tipo de Anestesia predominante foi a anestesia geral. Todas as pacientes apresentaram displasias benignas da mama nos histopatológicos de pós-operatórios. CONCLUSÃO: A técnica do pedículo inferior areolado mostrou-se adequada para o tratamento de grandes hipertrofias e ptoses mamárias.

INTRODUCTION: Reduction mammaplasty with the inferior pedicle nipple-areolar technique is widely used in North America but not in Brazil. Its main advantage lies in maintaining the sensitivity of the areola in large mammary ptoses. To describe the preoperative and postoperative characteristics of patients who underwent reduction mammaplasty with the inferior pedicle nipple-areolar technique at the Santa Casa de Campo Grande - MS in 2013. METHOD: We performed interview, physical examination, and review of medical records of patients operated by using this technique at this institution in 2013. RESULTS: Forty patients were evaluated. Their ages ranged from 21 to 68 years, with a mean of 40.62 years. The comorbidities reported were hypertension, diabetes, ulcerative colitis, disc herniation, and anxiety disorder. The average weight of resected tissue was 600.6 g from the right breast and 609.6 g from the left breast. The most common presurgery complaint was low back pain, followed by shoulder pain. The most frequent complications in the early postoperative phase were dehiscence of the mid-point of the strand (10%) and hematoma (5%). The predominant type of anesthesia was general anesthesia. All patients showed benign breast dysplasia in the postoperative histopathological examination. CONCLUSION: The inferior pedicle nipple-areolar technique was adequate for the treatment of major hypertrophies and mammary ptoses.

Recent Trend of the Reduction Mammaplasty and comparing with Vertical Reduction Method and Inverted T-scar Method

PURPOSE: The goal of reduction mammaplasty is breast with natural cone shape, minimizing scars, well-placed and sensate nipple-areolar area and maintaining breast physiology. In order to satisfy that goal, variable reduction mammaplasty methods are performed, however, two methods such as vertical reduction method and inverted T-scar method are currently most used. We compared indications and advantages of the two methods and set up useful guidlines. METHODS: For 15 years from 1995 to 2010, we experienced 84 patients(162 breasts). We performed vertical reduction method as Lejour's superior pedicle technique(45 patients) and inverted T-scar method as Goldwyn's inferior dermal flap technique(39 patients). We evaluated the result of the operation comparing patient's age, amount of resected tissue, complications and post-operative scars of the two methods. RESULTS: The mean age was 36 years and the vertical reduction group was 3 years younger than inverted T-scar group. The mean breast tissue resection amount per one breast, inverted T-scar group(712 gm) was lagger than vertical reduction group(395 gm). CONCLUSION: There is no ideal method for reduction mammaplasty until now. However, we suggest that guide line, the vertical reduction method is effective for minimal and moderate macromastia in young and middle aged women and inverted T-scar method is appropriate for severe macromastia with ptosis in elderly women. Recently, all procedures tried shorter and smaller scar on the vertical line as small I, J or L shape scar, and inframammary fold as short inverted T-scar.

Breast Reduction through an Inframammary Incision

PURPOSE: Reduction mammaplasty is a procedure with a relatively high patient satisfaction rate, however, associated scarring around the areola can be a serious problem. This study proposes a new modification of the breast reduction procedure by means of an inframammary incision alone. METHODS: The breast is marked out preoperatively with standing position. Under the general anesthesia, an inframammary incision of approximately 7-8cm is done. The subcutaneous plane is made in the lower pole of the breast, then the subglandular plane is entered and a sharp dissection is made up to 2cm below the areola. The breast is mobilized from the chest wall and a cone-shaped parenchyme is removed in en-block except from the retroareolar central part. The remaining both pillars are gathered together with absorbable sutures and the base of the gland is narrowed to project the breast forward. The wound is closed in a layered fashion and taping of the breast mound is applied to redistribute the breast skin. RESULTS: 21 patients(36 breasts) underwent this procedure from December 2004 to December 2009. Average follow up was 9 months(ranged from 6 months to 12 months). No major complication occurred. Most patients were pleased with the breast size, shape, and scars. However, 2 patients complained their hypertrophic scars which were corrected by revision. CONCLUSION: This technique is a simple approach to mild to moderate breast reduction through an inframammary incision alone. And, this technique provides an option with minimal complications and invisible scarring, which is especially important in the young patient group.

Secondary Reduction Mammaplasty using Different Pedicle from the Initial Pedicle: Report of Two Cases

PURPOSE: Reduction mammaplasty is one of the most commonly performed operations in plastic surgery. Although secondary surgery is occasionally required for minor aesthetic problems or for treatment of the complications of the primary surgery, there are no clear operative guidelines of management. We report here two cases of secondary reduction mammaplasty using differrent pedicle from the initial ones. METHODS: One case of secondary reduction mammaplasty were performed using medial pedicle after central (19 years) pedicle reduction mammaplasty because of subsequent breast ptosis and asymmetry. The other case was performed using medial pedicle after superior (4 years) pedicle reduction mammaplasty with contralateral immediate breast reconstruction with TRAM flap because of subsequent breast ptosis and asymmetry. Care was taken to include sufficient width of pedicle and adequate soft tissue attachment beneath the nipple-areolar complex. RESULTS: There was no significant complication such as nipple-areolar necrosis or fat necrosis. The results were well maintained throughout the follow-up period. CONCLUSION: Medial pedicle reduction mammaplasty can be safely performed after central or superior pedicle reduction mammaplasty when sufficient width of pedicle and adequate soft tissue attachment beneath the nippleareolar complex are maintained.

Modification of wise pattern based design with free nipple areolar complex graft in a case of juvenile hypertrophy of the breasts.

Juvenile hypertrophy of the breast (JHB) is a rare condition leading to gigantomastia unilaterally or bilaterally in peripubertal females. The pathology is limited usually to the breast, with otherwise normal growth and development and without any other deformities. The rapid bilateral or unilateral growth of the breast in adolescent girls leads to severe physical and psychological problems. The etiology remains elusive, but it is believed to represent an end-organ hypersensitivity during a period of intense endocrine regulatory stress. The best treatment is surgical whereas the younger patients better treated with mastectomy to anticipate the high recurrency rate, while older women is best treated with reduction mammaplasty. We report one case of a woman who had a unilateral JHB. The growth of the left breast started in her pubertal age and kept growing for one year. She was treated surgically with Wise pattern based design. After two years, she had no recurrent enlargement and aesthetically, the symmetry of both breasts is achieved with a satisfying scar.

Treatment of Gynecomatia in a Patient with Prader-Willi Syndrome

PURPOSE: Prader-Willi Syndrome(PWS) is a congenital chromosomal disorder characterized by compulsive and early development of obesity. Obesity is identified as the main cause of morbidity in PWS individuals. Also, body change for rapid weight gain, such as gynecomastia, can cause considerable functional and psychological trauma, We corrected successfully gynecomastia in PWS patient, so we reported our experience of surgical method and literature reviews. METHODS: A 16-year-old male patient presented with gynecomastia. He was diagnosed as with PWS at pediatric department. We performed reduction mammaplasty using inferior pedicle and Wise pattern. Excision amount was 1350g in right breast and 1415g in left breast. Also, we managed upper and lateral fullness of breast with liposuction. RESULTS: There were no specific complications, such as hematoma, infection, nipple-areola complex necrosis, and so on. Also, aesthetic and functional outcome was acceptable CONCLUSION: We experienced successful correction of gynecomastia in PWS patient, and found advantages of conventional reduction mammaplasty using inferior pedicle and Wise pattern at this specific situation.

Breast Reduction using Free Nipple Graft

PURPOSE: Free nipple graft reduction mammaplasty is a simple and effective way to reduce huge breasts. However, this technique is frequently criticized for producing poor projection and hypopigmentation of the nipple areola complex(NAC). METHODS: Sixty three patients(126 breasts) underwent the procedure from 1998 to 2005. Authors' method is similar with the modified Gradinger's technique except the keyhole pattern. After skin flap closing, the position of NAC is determined considering symmetry. The NAC is initially harvested and then resection of the breast followed, leaving a deepithelized inferior parenchymal pedicle(5 x 5cm). The upper point of inferior pedicle is sutured to the fascia of the pectoralis to produce the upper bulge. The nipple is replaced as a free and composite graft. RESULTS: An average of 823grams of breast tissue per breast was removed. There was no major complications. All grafted nipples showed long lasting projection. And also, all NAC eventually regained their normal color except for 3 patients who needed medical tattoos. The overall results were good and patient satisfactory score was high. CONCLUSION: This useful technique greatly enhances long lasting projection and recovers nipple color.

Breast Reduction using Free Nipple Graft

PURPOSE: Free nipple graft reduction mammaplasty is a simple and effective way to reduce huge breasts. However, this technique is frequently criticized for producing poor projection and hypopigmentation of the nipple areola complex(NAC). METHODS: Sixty three patients(126 breasts) underwent the procedure from 1998 to 2005. Authors' method is similar with the modified Gradinger's technique except the keyhole pattern. After skin flap closing, the position of NAC is determined considering symmetry. The NAC is initially harvested and then resection of the breast followed, leaving a deepithelized inferior parenchymal pedicle(5 x 5cm). The upper point of inferior pedicle is sutured to the fascia of the pectoralis to produce the upper bulge. The nipple is replaced as a free and composite graft. RESULTS: An average of 823grams of breast tissue per breast was removed. There was no major complications. All grafted nipples showed long lasting projection. And also, all NAC eventually regained their normal color except for 3 patients who needed medical tattoos. The overall results were good and patient satisfactory score was high. CONCLUSION: This useful technique greatly enhances long lasting projection and recovers nipple color.

Use of 2-Octylcyanoacrylate (Dermabond(R)) on Breast Surgery

This study is to compare a tissue adhesive, 2-octylcyanoacrylate (Dermabond(R)), with conventional wound closure techniques for vertical reduction mammaplasty. Twenty patients presenting large breast from November to December 2005 were enrolled into this prospective clinical trial study. These patients' breasts were randomly assigned to treatment with either 2-octylcyanoacrylate or 5-0 monofilament sutures. Photography taken at six months after treatment were rated by two plastic surgeons and six layperson blinded to the method of closure. There was no significant difference between the two groups for appearance scores based on a visual analog scale(81.9mm for 2-octylcyanoacrylate versus 75.7mm for 5-0 monofilament sutures). The length of time for periareoalr repair was decreased in the 2-octylcyanoacrylate group(2.7 minutes for 2-octylcyanoacrylate versus 8.3 minutes for 5-0 monofilament sutures, p<0.001). The patients' satisfaction rate in the 2-octylcyanoacrylate group was high. Moreover, the use of 2-octylcyanoacrylate obviates the need for suture removal. In conclusion, the use of 2-octylcyanoacrylate for vertical reduction mammaplasty is an acceptable alternative which includes several advantages to conventional suturing with a comparable cosmetic outcome.

Occult Breast Cancer in the Contralateral Reduction Mammaplasty Specimen in the Breast Reconstruction Patient

PURPOSE: Contralateral reduction mammaplasty at the time of breast reconstruction using autogenous tissue gives aesthetically improved results in the patients with mammary hypertrophy or ptosis. It also reduces required flap size for reconstruction and permits discarding zones of poor perfusion, decreasing flap size- related problems such as partial flap loss or fat necrosis. Considering the high rate of bilaterality of breast cancer, it also provides a good opportunity for exploration and occult cancer diagnosis in such high risk group patients. METHODS: We retrospectively reviewed 45 consecutive patients who underwent simultaneous breast reconstruction and contralateral reduction mammaplasty was performed about surgical technique, pathologic diagnosis, and subsequent treatment. RESULTS: Three occult breast cancers were found in 45 patients(6.7%); one was microinvasive, and the other two were invasive carcinomas and their mean diameter was 1.2 cm. One patient underwent subsequent breast conserving mastectomy, adjuvant radiation and chemotherapy. The others underwent only radiation and hormone therapy. They were followed up for 10 to 42 months without evidence of recurrence or metastasis. CONCLUSION: Occult breast cancer diagnosed in reduction mammaplasty specimen will lead to good prognosis due to its early detection. Treatment options depend on pathologic finding, stage, marginal status, and the timing of diagnosis. We recommend adequate markings for orientation and margins, excision with sufficient margin, and confirmation by frozen biopsy for suspected lesions.

New Trends in Reduction Mammaplasty

In Korea, reduction mammaplasty had not been performed because of ugly final scar. Recent decade, the number of patients who are suffering from large breast with back, neck, shoulder pain has been increased. And plastic surgeons are concerning about that kind of operarion. The inverted T method has been standard method for reduction mammaplasty. Many European and Brazilian plastic surgeons have developed their own methods with good results. Recent trend is focusing on the shape, projection, and scar of the breast, not on the design of skin excision. We discussed about various methods of reduction mammaplasty and their modifications which are fit for above principle.

Reduction Surgery for Giant Breast

PURPOSE: Women with large breasts suffer from both physical embarrassment and physical discomfort. Recently, partially due to socioeconomic development, growing numbers of woman with large breasts have sought reduction surgery, which previously had not been popular in Korea. At this time, a proper evaluation of the operation is required in order to promote the procedure. METHODS: Case files of 60 reduction operations using the inferior pedicle flap method for the reduction of large breasts were clinically reviewed. RESULTS: The patients were aged 19~65 (mean 34.5) years. The primary reasons for surgery were self-consciousness, shoulder/neck/back pain, wet skinfold/eczema and intractable mastalgia. Breast parenchymal pattern analysis by mammography revealed relatively a high frequency of dysplastic change (DY) among women with intractable breast pain, which was nearly entirely relieved by reduction surgery. The nipple-areolar complex were saved with inferior dermal pedicle flaps without any occurrence of necrosis. An average of 350 (range 50~800) grams of tissue from each breast was removed. There were no blood transfusions and significant postoperative complications were rare, although some patients complained of hypertrophic scars. CONCLUSION: Postoperative results were sufficiently satifactory to consider reduction surgery for inappropriately large breasts as a rehabilitative method.

Clinical Application of Reduction Mammaplasty with Various Methods

Breast has been considered as the symbol of the female. Ideal size of the breast was related to the age and culture. The goal of reduction mammaplasty is breast with natural cone shape, minimizing scars, well-placed and sensate nipple-areolar area and maintaining breast physiology. The ideal breast reduction should create beautiful breast with limited scars. We performed 37 cases of reduction mammaplasty. The techniques used were inferior dermal flap technique for 16 cases, vertical reduction mammaplasty for 18 cases, and periareolar round block technique for 3 cases. We compared advantages and disadvantages of the techniques and set up useful guide-lines to match the technique with the problem of each individual. The guidelines are as follow: 1. Inferior dermal pedicle technique is suitable for moderate to severe macromastia with ptosis. 2. Vertical reduction technique is effective for moderate macromastia in young women. 3. Periareolar round block technique is effective for mild to moderate macromastia in young women.

Reduction Surgery for Giant Breast / 한국유방암학회지

PURPOSE: Women with large breasts suffer from both physical embarrassment and physical discomfort. Recently, partially due to socioeconomic development, growing numbers of woman with large breasts have sought reduction surgery, which previously had not been popular in Korea. At this time, a proper evaluation of the operation is required in order to promote the procedure. METHODS: Case files of 60 reduction operations using the inferior pedicle flap method for the reduction of large breasts were clinically reviewed. RESULTS: The patients were aged 19~65 (mean 34.5) years. The primary reasons for surgery were self-consciousness, shoulder/neck/back pain, wet skinfold/eczema and intractable mastalgia. Breast parenchymal pattern analysis by mammography revealed relatively a high frequency of dysplastic change (DY) among women with intractable breast pain, which was nearly entirely relieved by reduction surgery. The nipple-areolar complex were saved with inferior dermal pedicle flaps without any occurrence of necrosis. An average of 350 (range 50~800) grams of tissue from each breast was removed. There were no blood transfusions and significant postoperative complications were rare, although some patients complained of hypertrophic scars. CONCLUSION: Postoperative results were sufficiently satifactory to consider reduction surgery for inappropriately large breasts as a rehabilitative method.

Reduction Surgery for Giant Breast / 한국유방암학회지

PURPOSE: Women with large breasts suffer from both physical embarrassment and physical discomfort. Recently, partially due to socioeconomic development, growing numbers of woman with large breasts have sought reduction surgery, which previously had not been popular in Korea. At this time, a proper evaluation of the operation is required in order to promote the procedure. METHODS: Case files of 60 reduction operations using the inferior pedicle flap method for the reduction of large breasts were clinically reviewed. RESULTS: The patients were aged 19~65 (mean 34.5) years. The primary reasons for surgery were self-consciousness, shoulder/neck/back pain, wet skinfold/eczema and intractable mastalgia. Breast parenchymal pattern analysis by mammography revealed relatively a high frequency of dysplastic change (DY) among women with intractable breast pain, which was nearly entirely relieved by reduction surgery. The nipple-areolar complex were saved with inferior dermal pedicle flaps without any occurrence of necrosis. An average of 350 (range 50~800) grams of tissue from each breast was removed. There were no blood transfusions and significant postoperative complications were rare, although some patients complained of hypertrophic scars. CONCLUSION: Postoperative results were sufficiently satifactory to consider reduction surgery for inappropriately large breasts as a rehabilitative method.