scholarly journals The expanded inframammary fold triangle: Improved results in large volume breast reductions

2014 ◽  
Vol 47 (01) ◽  
pp. 65-69 ◽  
Author(s):  
Karan Chopra ◽  
Kashyap Komarraju Tadisina ◽  
Alexandra Conde-Green ◽  
Devinder P Singh
Keyword(s):  
High Risk ◽  
Large Volume ◽  
Breast Reduction ◽  
Reduction Mammaplasty ◽  
Inframammary Fold ◽  
Wound Complications ◽  
Obese Patients ◽  
Inferior Pedicle ◽  
Improved Outcomes ◽  
Wise Pattern

ABSTRACT Context: The inferior pedicle, Wise-pattern reduction mammaplasty is the most popular technique for breast reduction because of its reproducible results and reliability. However, complication rates in super obese patients or patients receiving large volume reductions are high, ranging from 35 to 78%. These complications include delayed healing, infection, seroma, nipple-areolar complex necrosis, fat necrosis and development of hypertrophic scars. Aims: This study aimed to determine whether a modification to the standard Wise-pattern reduction technique, an expanded inframammary fold skin triangle, produces improved outcomes in high-risk large volume breast reduction patients. We report that this modification leads to improved outcomes by decreasing wound complications and improving aesthetic appearance. Settings and Design: Twenty-two patients received the inferior pedicle Wise-pattern reduction mammaplasty, which was modified to include an 8 cm wide inferior pedicle. This pedicle was de-epithelialized and an 8 Χ 3 cm 2 triangle of skin was preserved at the inferior base to reduce tension at the triple point, inverted T-closure. Materials and Methods: A retrospective review was performed on all patients who underwent reduction mammaplasty with the expanded inframammary fold (eIMF) technique as well as all patients who received the standard wise pattern technique. Statistical Analysis Used: A student t-test was performed for both reduction populations using SPSS software package. Statistical significance was defined as P < 0.05. Results: The average patient age was 32.25 years old (range 18-59), average BMI was 35.0, and average tissue mass removed per breast was 1378.39 g. The modified technique was found to produce a statistically significant (P < 0.05) increase in the amount of breast tissue removed (693.96 g increase in the left and 571.21 g in the right) as well as a statistically significant (P < 0.05) reduction in dehiscence (75% reduction) and post-operative infection (44.10%). Conclusions: This method is an easily reproducible and reliable technique that produces a favourable cosmetic outcome with acceptable, sustainable results in high-risk reductions in obese patients.

Improving Pseudoptosis in Robbins Reduction Mammaplasty

1994 ◽  
Vol 2 (2) ◽  
pp. 71-74
Author(s):  
Arnis Freiberg ◽  
Michele M Carr
Keyword(s):  
Breast Tissue ◽  
Reduction Mammaplasty ◽  
Inframammary Fold ◽  
Inferior Pedicle ◽  
Nipple Areolar Complex ◽  
Original Technique ◽  
Expected Result ◽  
Areolar Complex ◽  
Mound Construction

A Freiberg, MM Carr. Improving pseudoptosis in Robbins reduction mammaplasty. Can J Plast Surg 1994;2(2):71–74. The problem of the high nipple is frequently observed after reduction mammaplasty. Our hypothesis was that this deformity could be avoided with proper nipple-areolar complex (nac) placement. The original Robbins inferior pedicle reduction mammaplasty was modified by the placement of the nac intraoperatively at the completion of the breast mound construction. One hundred and fifty-three consecutive patients were followed after reduction mammaplasty. Pseudoptosis, defined as a nac above the inframammary fold while the breast tissue appeared to have descended, was graded as mild, moderate or severe. Individuals were classified by two independent observers. Frequency and degree of pseudoptosis in the original technique was significantly greater than in the modified group. In both groups there was no relationship between number of years postoperative or amount of breast excised and pseudoptosis. Incidence of pseudoptosis was related to breast type and possibly pregnancy in both groups. We conclude that pseudoptosis is likely a result of an initial improper nac placement as opposed to an expected result of reduction mammaplasty.

Reduction Mammoplasty

2019 ◽  
pp. 649-664
Author(s):  
M. Mark Mofid ◽  
Gehaan D’Souza ◽  
Benjamin E. Cohen ◽  
Michael E. Ciaravino
Keyword(s):  
Patient Satisfaction ◽  
Breast Reduction ◽  
Reduction Mammaplasty ◽  
Well Being ◽  
The United States ◽  
Reduction Mammoplasty ◽  
Strongly Correlated ◽  
Breast Reduction Surgery ◽  
Developmental Factors ◽  
Wise Pattern

Breast reduction is one of the more common plastic surgery operations performed in the United States. There were 1,00,000 operations performed in 2015. The etiology of breast hypertrophy is unclear and likely involves some combination of hormonal, genetic, and developmental factors. Patients with mammary hypertrophy complain of intertriginous infections, back and shoulder pain, shoulder notching, physical inactivity, dissatisfaction with breast appearance, poor sexual well-being, and poor psychological well-being. The goals of breast reduction surgery are to reduce overall breast volume, maintain nipple-areola viability, and achieve a shape that is aesthetically pleasing. Breast reduction improves patient satisfaction with breast appearance as well as physical and psychosocial well-being. Overall patient satisfaction is most strongly correlated with happiness with the appearance of the breasts. A number of techniques have been developed that effectively meet these goals. Three techniques are described in this chapter: inferior pedicle Wise pattern reduction mammaplasty, vertical pattern breast reduction, and partial breast amputation with free nipple-areola grafting.

scholarly journals The Hybrid Breast Reduction; Taking Advantages of from Both the Vertical and Wise Pattern Reductions

2016 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Breast Reduction ◽  
Reduction Mammaplasty ◽  
Skin Incision ◽  
Hybrid Technique ◽  
Vertical Scar ◽  
Aesthetic Result ◽  
Advantages And Disadvantages ◽  
Type Pattern ◽  
Wise Pattern ◽  
Breast Projection

Reduction mammaplasty is one of the most commonly performed procedures by plastic surgeons. The Wise and vertical scar techniques are two of the most commonly published and performed techniques. The superior technique has long been argued. The advantages and disadvantages of each are well documented. We show a technique which combines the best aspects of the Wise and vertical pattern reductions. In this “Hybrid” technique, we use a typical superior medical pedicle that would be typically used in a vertical pattern and use a skin incision and tissue resection pattern of that of a Wise type pattern. By doing using this technique , the surgeon is able to utilize advantages of the two well-known reduction types. The hybrid reduction uses a robust and reliable superior type pedicle which also allows for a quick de epithelization and dissection of the pedicle. By using the Wise type (anchor shaped skin incision) a large amount of tissue is able to be harvested and the breast projection is restored and is aesthetically favorable. This paper outlines several important points which can aid in achieving an optimal aesthetic result when performing the hybrid breast reduction.

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