The Department of Plastic Surgery, Faculty of Medicine, Alexandria University, Egypt

Abstract

Background: The inferior pedicle wise pattern breastreduction is one of the most popular techniques used. However,a major criticism of inferior pedicle technique is bottomingout of the breast and lack of upper pole fullness. This is causedby gravitational pressure of the breast parenchyma/pedicleon the inferior pole with subsequent scaphoid appearance inthe upper pole and lengthening of the vertical scar. In thisstudy, a modification of the inferior pedicle technique will bedone by creation of two lateral dermal flaps alongside withthe inferior pedicle, and using these flaps to suspend thepedicle to the chest wall and prevent its descent to evaluateits effect on prevention of bottoming out of the breast.Patients and Methods: This is a prospective randomizedstudy that included 20 healthy female patients suffering frombreast hypertrophy and they are candidate for reductionmammoplasty by the proposed technique. Design of skinmarking for inferior pedicle breast reduction technique wascarried out with the standard wise pattern with the creationof two wings (medial and lateral) at the middle of the inferiorpedicle; composed of de-epithelialized dermal flaps. Buttressingthese two wings to the pectoral fascia at the suitabledistances would create a sort of an internal bra effect; whichsupports the inferior pedicle. During the follow up, the lengthof the vertical scar (as an indicator of bottoming out) wasmeasured immediately postoperative and every 3 months inthe follow-up period. Results: This study includes 20 female patients of an ageranged between 22-51 years old and a breast size (suprasternalnotch to nipple distance) ranging from 31 to 44cm. The followupfor 1-year post-operative shows change in the areola tofold distance by a ratio satisfaction reaching 60%.Conclusion: From this study we concluded that the inferiorpedicle suspension to pectoral fascia improve the result shapeof the breast and decrease the bottoming out of the breast.