Superior pedicle breast reduction and comma-shaped mammoplasties

Abstract

INTRODUCTION In recent years, breast conservation procedures have only been carried out where breast resection can ensure favorable cosmetic results. Despite careful surgical technique and attention to esthetic detail, sometimes the cosmetic results are not optimal (Fig. 1A-C) and often a contralateral procedure is necessary to achieve acceptable breast symmetry and overall good cosmesis. Unfavorable cosmetic results often occur following breast conservation surgery for two basic reasons: (i) location of the tumor in the lower quadrants of the breast, (ii) extensive resections in relatively small-to medium-sized breasts, and (iii) failing to reapproximate the glandular tissue of the breast with resultant deformity and unsightly indentation of the breast mound. Techniques are now available for partial breast reconstruction following breast conservation therapy and these should be considered in conjunction with a contralateral adjustment for better symmetry (1-3). The superior pedicle mammoplasty is suitable for wide excision of tumors in the 5, 6, and 7 o’clock positions, whereas the comma-shaped mammoplasty is preferable only in the 6 o’clock position of the breast. These techniques together with the inferior pedicle breast reduction are also used routinely for contralateral adjustment to achieve good symmetry after mastectomy and breast reconstruction.