Abstract
Reduction mammoplasty is the gold standard procedure for symptomatic breast hypertrophy and it is also used for contralateral breast symmetrisation following breast cancer surgery. We aim at introducing a new procedure, which uses an omega resection pattern to simplify the inferior pedicle breast resection technique. A retrospective review of all patients who underwent the omega resection reduction mammoplasty at the University Hospital of Basel between 2010 and 2020 was carried out. We collected patient demographics, surgical outcomes, operation time, type and frequency of complications at 12 months follow-up. Outcomes were compared with the most commonly used techniques. Additionally, we assessed if patients’ and clinical characteristics augmented/diminished the complication rate. During the study period, 67 reduction mammaplasties were performed by a senior plastic surgeon (Mage = 42.5, SDage = 15.6; MBMI = 27.28, SDBMI = 3.4; 20% smokers). The average tissue removed was 826 g (ranging from 15 to 2307 g). In 10 breasts (15%) occurred minor complications. No major complications were reported. Operation time (M = 149 min; ranging from 87 to 270 min) was significantly shorter than the inferior, superomedial, and superior pedicle techniques. Univariate Odd Ratios showed that no-smoker status, a BMI in a normal range, resection weight between 500 g to 1500 g, NTN distance < 30 cm, removal of drains one day after the operation, ASA index of 2, inpatient clinic hospitalisation, and not undergoing other concomitant surgical operations were protective factors against the risk to develop complications. The omega resection pattern technique demonstrated to be an effective, safe, and fast mammoplasty reduction procedure for bilateral macromastia and unilateral symmetrizing procedures, even for large breasts, able to be adopted as a new valid alternative to the existing ones.
Highlights
Symptomatic hypermastia affects the quality of life of millions of women worldwide.The most frequent symptoms showed by more than two-thirds of patients are shoulder grooving, and back, shoulder, and neck pain [1]
Demographic information collected from the patients included age, smoking status, Body Mass Index (BMI), sternal notch-to-nipple distance (NTN), and American Society of Anesthesia (ASA) physical status
Breast reduction is the gold standard procedure to treat symptomatic hypermastia [1,2,3,4,5], and it improves the aesthetic outcomes in contralateral breast symmetrisation procedures following breast cancer surgery [9]
Summary
The most frequent symptoms showed by more than two-thirds of patients are shoulder grooving, and back, shoulder, and neck pain [1]. Patients usually report as other frequent complaints discomfort during sleep, pain, and marks in the bra-strap groove, on the shoulders and below the breasts, difficulty in dressing, skin lesions and decreased self-confidence, with an overall negative impact on their quality of life [1,2,3]. Reduction mammoplasty is considered the gold standard choice for symptomatic breast hypertrophy treatment [1,6,7]. Breast reduction is the seventh most performed procedure by plastic surgeons worldwide and, according to the 2019 International Society of Aesthetic Plastic Surgery (ISAPS) statistics [8], it showed a 12.3% increase over the number of procedures performed in 2018 and even a 41.9% increase compared to 2015
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