Breast Reduction Technique Research Articles

Reduction Mammoplasty with Free-Nipple Transplantation: Indications and Technical Refinements

Multiple techniques for breast reduction have been proposed. For carefully selected women with macromastia, the technique of choice may be amputation mammoplasty with free nipple-areolar grafting. These select groups include the following: the poor-risk elderly, women with systemic disease that could affect the vascularity of the skin flaps or impair wound healing, women with previous operative procedures in the breast affecting skin flap or pedicle vascularity, and women with indications for removal of tissue in the region of the inferior pedicle. Our experience demonstrates that in these high-risk women, amputation mammoplasty with certain technical refinements provides an aesthetic safe result without significant perioperative surgical or medical complications. A clinical series is presented with an average follow-up of 2.75 years.

The Regnault “B” technique in mastopexy and breast reduction

The Regnault “B” technique in mastopexy and breast reduction

The inferior dermal-pyramidal type breast reduction: long-term evaluation.

The evolution of the technique of breast reduction using an inferior dermal pyramidal flap is discussed, including the changes we have found to enhance this procedure. The recommended use of a wide-based pyramidal breast parenchyma with a dermal pedicle nipple-areola flap is based on our 12-year study of 1,001 breast reductions in 519 patients ranging in age from 13 to 73 years; 37 of the patients underwent a unilateral breast reduction. The weight of tissue excised ranged from 207 g to 3,350 g from each breast. Occult carcinomas were found in two of the breast specimens. The longest sternal notch-to-nipple distance was 52 cm. The essential goals of predictability of the result, retainment of nipple sensitivity, excellent aesthetic results, and the possibility of lactation are satisfied by the use of this surgical technique. This technique appears to have continued application in younger women, in whom nipple sensation and lactation are particularly important.

The Regnault "B" technique in mastopexy and breast reduction: a 12-year review.

The "B" technique for mastopexy and reduction with and without prosthesis has been used by the author over the last 12 years for all forms of breast ptosis and hypertrophy. It has been used consistently and uniquely in over 1000 cases. Its cosmetic advantages are the short length of the scar, avoidance of a median projection of the scar, and a beautiful roundness in the best cases. The technique proved to be very adaptable to various deformities and is easy to use. The percent of complications is thought to be no greater than that of other techniques.

Superomedial pedicle technique of reduction mammaplasty.

A series of 148 patients who underwent reduction mammaplasty utilizing the superomedial pedicle technique is presented. Resections as large as 4100 gm per breast with nipple-areola transpositions up to 30 cm were done with reliable nipple-areola survival, including preservation of sensation. The superior pedicle technique of breast reduction is recognized by many as technically easier and capable of producing a longer-lasting aesthetic effect. Classically, however, it has been limited to smaller resections. By incorporating the medial quadrant in the superior pedicle, more aggressive reductions can be safely undertaken with the same excellent results. Details of the procedure, the anatomic basis for its success, and complications are discussed.

Prevention of the teardrop areola following the inferior pedicle technique of breast reduction.

Elevation of the inferior portion of the areola with placement of dermal traction sutures will reduce the risk of an inverted teardrop areola deformity following inferior pedicle reduction mammaplasty. The long-term results in creation of a circular areola have been uniformly successful.

Breast reduction for asymmetrical hypertrophy.

Design details of reduction of asymmetrical hypertrophy of the breasts are discussed. The concepts apply to nearly any breast reduction technique, although here they are presented in the context of the inferior segment method, which we favor. Although most of these points may seem self-evident to the experienced plastic surgeon, there has been little written about the details.

The inferior segment technique for breast reduction

The inferior segment technique for breast reduction

Dermoadipose and adenadipose flaps in mammoplasty.

After the follow-up of breasts operated on using several breast reduction techniques that resect the glands removing its central section, we noted in the last postoperative period that with the passage of time, these breasts developed a depression on the upper pole causing a somewhat ungraceful profile and the visual impression that the breast was ptotic. It was noted that the techniques used were most concerned with mammary gland removal, without specific regard to the upper pole of the breast. Searching for an aesthetic solution for the construction and maintenance of the upper pole of the breast, we have developed two techniques in which fixation of mammary tissue flaps to the third costal arch assures both a graceful breast and pexis of the breasts. This report presents an analysis of the results of the author's experience.

The inferior segment technique for breast reduction.

The major objectives in any breast reduction operation are to decrease the size of the breasts while providing a normal shape, preserving sensibility of the nipple, and permitting lactation in the premenopausal patient. The inferior segment technique of breast reduction is presented, with emphasis on the points we consider crucial for achieving these objectives.

New refinements in vertical mammaplasty

A few years ago 1 published a technique of breast reduction, resulting in a vertical scar. Actually, a two or three centimeters scar appearing beyond the brassiere line is no more accepted by the patients; so 1 modified the technique. The new one ends in a vertical line and a very short horizontal one which gives in the opinion of the author the minimum scarring in this kind of operation.

Some remarks on breast reduction by the “B” technique

The main disadvantage of the popular techniques for breast reduction are the scars left around the breasts. We present our experience with the "B" technique for breast reduction, which creates a much smaller size scar that is well hidden under the brassiere. Our conclusion is that the "B" technique is the method of choice for most breast reductions.

Mammary Asymmetry

Significant mammary asymmetry is not uncommon, although accurate statistics are not available. Modern techniques of mammary augmentation and breast reduction have resulted in effective methods of treatment of most such deformities.