Effect of pedicle type on breast reduction: Clinical and patient-reported outcomes

Abstract

PurposeThe choice of pedicle in reduction mammaplasty is highly variable with prior studies demonstrating high patient satisfaction in the majority. This study aims to examine the impact of pedicle type on clinical and patient-reported outcomes in patients undergoing reduction mammaplasty. MethodsA total of 588 patients underwent a bilateral reduction mammaplasty with a wise-pattern or modified-Robertson incision by 13 surgeons at a single institution. Clinical outcomes were compared according to pedicle type in all patients and BREAST-Q responders (32% response rate). Survey respondents were sub-grouped by resection volume and BREAST-Q satisfaction scores were compared. ResultsAmong all included reduction mammoplasties, 439 (75%) were performed using an inferior pedicle, and 149 (25% using a superior or superomedial pedicle. Responders and non-responders were similar in preoperative characteristics including age, body measurements, and comorbidities. While a higher incidence of infection occurred among responders, clinical outcomes were comparable across pedicle types. A total of 187 patients completed the BREAST-Q. Compared to the superior pedicle group, respondents with inferior pedicles reported higher nipple satisfaction, even when adjusted for resection weight over 500 grams. In contrast, the superior pedicle had sexual well-being scores, which persisted in resection weight less than 500 grams, (all p values < 0.05). ConclusionInferior pedicles were associated with greater nipple satisfaction and superior pedicles were associated with greater sexual satisfaction. Our findings suggest that those with resections less than 500 grams were more satisfied with superior pedicles whereas those with greater resections were more satisfied with inferior pedicles.