Inferior pedicle with inverted-T procedure for bilateral reduction mammoplasty provided satisfactory surgical and aesthetic outcome

Authors

  • Waseem A. Shod Department of General Surgery, Mansoura Military Hospital, Mansoura, Egypt

DOI:

https://doi.org/10.18203/2349-2902.isj20210910

Keywords:

Macromastia, Reduction mammoplasty, Aesthetic outcome, Quality of life

Abstract

Background: The objective of the study was to evaluate surgical and aesthetic outcomes of bilateral reduction mammoplasty (RM) through the inferior pedicle with inverted-T approach (PO).

Methods: 23 women with bilateral symptomatizing macromastia underwent preoperative breast measurements, calculation of breast volume (BV), determination of quality of life (QoL) and self-esteem scorings using the breast reduction assessed severity scale (BRASS) and the Rosenberg self-esteem scale (RSES). RM was performed and intraoperative and PO data were collected. At 3-m PO, aesthetic outcome was evaluated using the ABNSW score, which assesses breasts asymmetry and shape, nipple deformation, skin condition and wound scar, and QoL outcome and overall satisfaction were determined.

Results: Mean operative time was 240.4±39.7 min and mean weight of excised breast tissue was 2778.3±307.7 gm. Minor PO complications were managed conservatively and no patient required revision surgery. PO breast measurements were significantly improved with decreased BV and increased breast projection. Median ABNSW score was 10 and PO median BRASS and RSES scores were 9 and 17 with significant change in comparison to preoperative data. Preoperative BRASS score was negatively correlated age and body mass index, while RSES score was positively correlated with age. Nine women were highly satisfied by aesthetic outcome, 10 women were satisfied and 16 women were highly satisfied with overall outcome.

Conclusions: RM significantly improved women QoL, aesthetic appearance and psychological status. Inferior pedicle with inverted T-mammoplasty is a safe, and applicable pattern of mammoplasty, allow significant reduction of BV with improved breast measurements and projection and provide satisfactory aesthetic outcome.

References

Fino P, Di Taranto G, Toscani M, Scuderi N. Breast reduction: personal technique. Clin Ter. 2016;167(6):167-70.

Fairchild B, Wei S, Bartz-Kurycki M, Rose J, Greives M. The Influence of Obesity on Outcomes After Pediatric Reduction Mammaplasty: A Retrospective Analysis of the Pediatric National Surgical Quality Improvement Program-Pediatric Database. Ann Plast Surg. 2020;85(6):608-11.

Jud S, Brendle-Behnisch A, Hack C, Preuss C, Arkudas A, Horch R, et al. Macromastia: an economic burden? A disease cost analysis based on real-world data in Germany. Arch Gynecol Obstet. 2020.

Egozi D, Allwies T, Fishel R, Jacobi E, Lemberger M. Free Nipple Grafting and Nipple Sharing in Autologous Breast Reconstruction after Mastectomy. Plast Reconstr Surg Glob Open. 2020;8(9):3138.

Chetty V, Ndobe E. Macromastia and gigantomastia: efficacy of the superomedial pedicle pattern for breast reduction surgery. S Afr J Surg. 2016;54(4):46-50.

Lo A, Yu R, Raghuram A, Khim P, Wang S, Manoukian H, et al. Patient Characteristics Associated with Free Nipple Graft Reduction Mammoplasty Cureus. 2020;12(7):9063.

Roei S, Gal B, Tariq Z, Arik Z, Amir I, Eyal G, et al. Superiomedial Pedicle Breast Reduction for Gigantic Breast Hypertrophy: Experience in 341 Breasts and Suggested Safety Modifications. Aesthetic Plast Surg; 2020.

Bustos S, Molinar V, Kuruoglu D, Cespedes-Gomez O, Sharaf B, Martinez-Jorge J, et al. Inferior pedicle breast reduction and long nipple-to-inframammary fold distance: How long is safe? J Plast Reconstr Aesthet Surg. 2020;1748-6815(20):30469-1.

Restifo R. The Pedicled Robertson Mammaplasty: Minimization of Complications in Obese Patients with Extreme Macromastia Aesthet Surg J. 2020;40(12):666-75.

Longo B, Farcomeni A, Ferri G, Campanale A, Sorotos M, Santanelli F. The BREAST-V: a unifying predictive formula for volume assessment in small, medium, and large breasts. Plast Reconstr Surg. 2013;132:1-7.

Yamashita K. Cosmetic Assessment. J Japan Soc Endoscop Surg. 2004;10:165-70.

Antony A, Yegiyants S, Danielson K, Wisel S, Morris D, Dolezal R, et al. A matched cohort study of superomedial pedicle vertical scar breast reduction (100 breasts) and traditional inferior pedicle Wise-pattern reduction (100 breasts): an outcomes study over 3 years. Plast Reconstr Surg. 2013;132(5):1068-76.

Kemaloğlu C, Özocak H. Comparative Outcomes of Inferior Pedicle and Superomedial Pedicle Technique with Wise Pattern Reduction in Gigantomastic Patients. Ann Plast Surg. 2018;80(3):217-22.

Baslaim M, Al-Amoudi S, Hafiz M, Al-Hazmi W, Salman B, Al-Amoudi M. The Safety, Cosmetic Outcome, and Patient Satisfaction after Inferior Pedicle Reduction Mammaplasty for Significant Macromastia. Plast Reconstr Surg Glob Open. 2018;6(6):1798.

Kulkarni K, Egro F, Kenny E, Stavros A, Grunwaldt L. Reduction Mammaplasty in Adolescents: A Comparison of Wise and Vertical Incision Patterns. Plast Reconstr Surg Glob Open. 2019;7(12):2516.

Lewin R, Lidén M, Lundberg J, Hansson E, Selvaggi G, Thorarinsson A, et al. Prospective Evaluation of Health After Breast Reduction Surgery Using the Breast-Q, Short-Form 36, Breast-Related Symptoms Questionnaire, and Modified Breast Evaluation Questionnaire. Ann Plast Surg. 2019; 83(2):143-51.

Krucoff K, Carlson A, Shammas R, Mundy L, Lee H, Georgiade G. Breast-Related Quality of Life in Young Reduction Mammaplasty Patients: A Long-Term Follow-Up Using the BREAST-Q. Plast Reconstr Surg. 2019;144(5):743-50.

Nuzzi L, Firriolo J, Pike C, DiVasta A, Labow B. Complications and Quality of Life following Reduction Mammaplasty in Adolescents and Young Women. Plast Reconstr Surg. 2019;144(3):572-81.

Crittenden T, Watson D, Ratcliffe J, Griffin P, Dean N. Outcomes of Breast Reduction Surgery Using the BREAST-Q: A Prospective Study and Comparison with Normative Data. Plast Reconstr Surg. 2019;144(5):1034-44.

Silhol T, Chaouat M, Noel W, Mimoun M, Boccara D. Interindividual and Intraindividual Variations of Breast Sensitivity Before and After Breast Reduction: A Prospective Study. Ann Plast Surg. 2020.

Lin Y, Yang Y, Zhang X, Li W, Li H, Mu D. Postoperative Health-related Quality of Life in Reduction Mammaplasty: A Systematic Review and Meta-Analysis. Ann Plast Surg. 2020.

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Published

2021-02-25

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Original Research Articles