Breast Reduction and Mastopexy

Abstract

A vast array of techniques have been developed and abandoned since the first reported breast reduction by Dieffenbach, 160 years ago. The current trend, particularly in Europe, is toward short scar techniques. In this chapter the pertinent aspects of breast anatomy and physiology are delineated as well as the medical indications and psychological aspects inherent in macromastia patients. In addition, necessary preoperative classification and planning are discussed in conjunction with technique selection and execution. This is followed by a detailed description and step-by-step photograph demonstration of our preferred technique, mainly influenced by the Z-plasty technique of Maillard and the short vertical scar technique of Lassus. The complication and revision rates of major studies are compared to our own series of 3,554 breast reductions using this technique. Finally, the medicolegal aspects are discussed focusing on the fact that breast reductions and mastopexies are the most frequent causes of law suits in plastic surgery in the U.S. due to scar problems.