18 - Breast Reduction—Medial Pedicle Technique

Abstract

Breast reduction is a common procedure performed by plastic surgeons for functional or cosmetic improvement of the breast. However, final outcome can be less satisfactory to patients in terms of the size, shape, symmetry, scarring, or wound healing complications. Nevertheless, good to excellent outcome after breast reduction can be accomplished by plastic surgeons once they have mastered the technique. The medial pedicle vertical breast reduction has been popularized recently. Unfortunately, the technique is technically more demanding; the results have been less inconsistent with a learning curve. In addition, the technique has been criticized for a residual deformity in the lower pole of the breast and has resulted in a high revision rate. In this chapter, key components for the medial pedicle vertical breast reduction, including patient selection and technical refinements, are described in detail. The author introduces his philosophy in patient selection, preoperative and intraoperative markings of the breast, and step-by-step surgical procedures with several technical refinements for the medial pedicle breast reduction. In addition, the pearls for achieving an optimal outcome and management of complications for medial breast reduction are also discussed.