Bipedicle Vertical Mammoplasty Associated with Liposuction/Lipotunnelization.

Abstract

Vertical techniques have become more popular and versatile in breast reduction and mastopexy procedures. The authors introduce a combination of vertical mammoplasty with vertical bipedicle technique, presenting some innovations concerning pedicle design, glandular dissection pattern, and the role of liposuction. In this article, we describe a personal surgical technique and analyze the results on 73 mastopexy and breast reduction patients, operated on between 2012 and 2014 by the senior author. The most important aspects of this technique are as follows: 1. the concept of lipotunnelization, where parenchymal tunnels are made with cannulas without suction; 2. the systematic use of liposuction/lipotunnelization to recreate the inframammary fold and decrease pillars height; 3. the use of a thick and narrow vertical pedicle (bipedicled); 4. no skin undermining. Twenty-five patients underwent mastopexy and 48 breast reduction. Results were evaluated by clinical examination and patient photographs. Good shape and projection of the breast and correct nipple elevation were achieved, correlating with a high level of patient satisfaction. No major complications occurred. This lipomammoplasty technique is a reliable and effective option, suitable for a wide range of symptomatic macromastia/ptosis. Adjunctive use of liposuction/lipotunnelization in vertical breast reduction accomplishes effective contouring of the breast with low associated complications and significantly reduces the revision rates. This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .