A Novel Technique for Correction of Bottoming Out Following Inferior Pedicle Breast Reduction

Abstract

Introduction: Bottoming out is a frequent pitfall of breastreduction following inferior pedicle technique. This is attributedto the lack of deep tissue suspension and skin enveloperelaxation. The condition is associated with lack of medialfullness and poor projection. The authors present a newtechnique that depends on redistribution and auto-augmentationrather than resection of tissues.Patients and Methods: The technique was performed in25 patients who had bottoming out following inferior pediclebreast reduction. The time elapsed from the primary surgeryto the corrective surgery ranged from 2 to 4.5 years with amean of 2.5 years. The used technique consists of deepithelializationand complete division of the lower segment at theinfra-mammary fold. The divided lower dermoglandularsegment is rolled in a retromammary pocket underneath thepedicle and fixed to the pectoral fascia. The idea is to use thislower segment of the inferior pedicle as an auto-prosthesis.Follow-up period is 12 months.Results: All patients achieved good breast shape withgood projection. There were no serious complications. Onlytwo patients developed partial wound disruption.Conclusion: A novel technique for correction of bottomingout following inferior pedicle breast reduction was used withgood surgical outcome