Periareolar Reductioon Mammoplasty: Inferior Dermal Pedicle VS. Central Parenchymal Pedicle-Experiences of 60 patients

ABSTRACT

After the introduction of the central parenchymal pedicle by Hester(1985) and the round-block technique by Benelli (1988), several variations of periareolar reduction mammoplasty have been used by many authors. Periareolar reduction mammoplasty is a less aggressive procedure than traditional techniques and it produces less conspicuous periareolar scars while maintaining an acceptable overall result. We experienced 120 cases (60 patients) of periareolar reduction mammoplasty during the period from May 1994 to February 1998. We present the analysis of 60 cases of periareolar reduction mammoplasty. Periareolar reduction mammoplasty utilizing central parenchymal pedicle was performed in the first 40 patients, while a procedure utilizing the inferior dermal pedicle was done in the next 20 cases consecutively. The range of follow-up was from 1 to 5 years. Complications such as nipple areolar complex necrosis and sensory changes were reduced when the inferior dermal pedicle used. There were 5 cases of nipple areolar complex necrosis and sensory changes were reduced when the inferior dermal pedicle used. There were 5 cases of nipple areolar complex necrosis (6.2%), including 1 case of near total necrosis in cases utilizing the central parenchymal pedicle. But in the technique using inferior dermal pedicle, there was no skin flap necrosis. The central parenchymal pedicle technique has several advantages such as a wide operation field permitting complete breast contouring and better mobility of the remaining breast tissue. However, inferior dermal pedicle technique has relative superiority over central parenchymal pedicle technique in terms of anatomical rationale, as well as in the rate of complications without causing limitations in breast mobility for contouring. Such complications as nipple areolar complex necrosis, skin flap necrosis and sensory change of nipple were reduced when the inferior dermal pedicle technique was used. It is much easier to preserve the 4th intercostal nerve to the nipple anatomically. Periareolar reduction mammoplasty utilizing the inferior dermal pedicle is thought to be a reliable, reproducible method.