Safety and Aesthetic Improvement Using the Omega Pattern Reduction Mammaplasty after Breast Conservation Surgery and Radiation Therapy

Abstract

With the continued popularity of lumpectomy and radiation therapy for many early-stage breast cancer patients, a considerable number of large-breasted patients are being identified who are unhappy with subsequent asymmetry and cosmetic distortion and symptoms related to their macromastia. Bilateral reduction mammaplasty is the most direct means of achieving size balance, improving cosmesis, and relieving symptoms related to macromastia. However, most plastic surgeons are fearful of reduction of the irradiated breast using traditional pedicle techniques for nipple transfer. An alternative procedure intended to minimize this risk is the reduction mammaplasty with an omega incision. The omega technique uses a central excision resulting in a moderate resection of skin and breast tissue while elevating the nipple-areola complex. Between 2001 and 2005, the authors used the omega reduction technique in five post-lumpectomy and irradiation patients with resultant large, asymmetric breasts. The volume of excised tissue from the irradiated breast was 250 to 327 g (mean, 291 g). All patients were relieved of their preoperative macromastia symptoms and achieved improved breast symmetry. In addition, there were no wound healing complications, and all women were satisfied with their cosmetic result. The omega breast reduction technique creates the widest possible pedicle with the least length, thus maximizing blood supply and avoiding the development of more tenuous flaps and a separate nipple pedicle. The authors believe it is a safer technique for the correction of breast asymmetry and improvement in symptomatic macromastia in patients who have previously undergone lumpectomy and radiation therapy.