ABSTRACT
BACKGROUND: During 30 months, 40 "septum-based" mammaplasties with a craniomedial pedicle were performed. This report aims to demonstrate the anatomic basics of the horizontal septum and the authors' experience with the septum-based mammaplasty technique. METHODS: A series of 40 consecutive patients underwent a "septum-based" mammaplasty. This technique uses a medial pedicle based on Würinger;s horizontal septum, which is the main plain for the neural and vascular supply of the nipple-areolar complex (NAC). RESULTS: The mean nipple-to-sternal-notch distance was 32 cm (range, 24-43 cm). The mean resection weight was 648 g (range, 484-1,320 g), and the mean nipple elevation was 9.5 cm (range, 5-18 cm). There were no hematomas and no partial or complete NAC necroses. Minimal wound dehiscence at the T-junction was present in three cases (7.5%). The pre- and postoperative NAC sensibilities were comparable in all the patients. CONCLUSION: Based on Würinger;s horizontal septum, a safe and well-vascularized mammaplasty is possible even with large resection weights and long nipple-areola distances, and NAC sensibility can be preserved. The reported technique combining excellent pedicle perfusion with a wide variety of breast shaping proved to be safe.