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Gland Surg 2022 Mar;11(3):524-534

Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.

Background: Large and ptotic breasts are considered an anatomical contraindication for nipple sparing mastectomy (NSM). Necrosis rates can be as high as 76%. The authors examined whether targeted preshaping mastopexy/reduction combined with simultaneous two-stage preshaping of the implant pocket prepares for an uneventful implant reconstruction. Read More

Plast Reconstr Surg Glob Open 2022 Feb 17;10(2):e4105. Epub 2022 Feb 17.

Ingress Medical Centre and University of Cape Town, Cape Town, South Africa.

In macromastia, especially in patients with a raised BMI, the nipple areola complex (NAC) may be displaced from the breast midline/meridian. This is poorly documented, and there is little published on surgical management. The aim of the study was to identify the incidence of displaced NAC in macromastia and discuss the management using the superomedial pedicle, by canting the vertical limbs of the inverted T/keyhole. Read More

J Plast Reconstr Aesthet Surg 2022 03 14;75(3):1179-1186. Epub 2021 Nov 14.

Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.

Background: In breast reduction, traditionally the inferior pedicle (IFP) technique is considered the most performed by plastic surgeons. A growing interest for the superomedial pedicle (SMP) mammoplasty technique has been documented in literature and clinical practice. Sensory recovery of the nipple-areolar complex (NAC), final areolar shape and scarring may also have a significant impact on patient satisfaction. Read More

Indian J Plast Surg 2021 Sep 13;54(3):264-271. Epub 2021 Sep 13.

Department of Plastic and Reconstructive Surgery, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

This article is an attempt to formulate certain guidelines for planning of zone-wise reconstruction after breast conservation surgery. The planning involves applying reduction mammoplasty principles with certain modifications to address the defect. This is a retrospective study of 61 patients with breast cancer who underwent breast conservation surgery and reconstruction of partial breast defects with oncoplastic techniques between January 2014 to March 2019. Read More

J Clin Med 2021 Sep 27;10(19). Epub 2021 Sep 27.

Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland.

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. Read More

Aesthetic Plast Surg 2022 Feb 5;46(1):108-112. Epub 2021 Aug 5.

Henry Ford Health System, Detroit, MI, USA.

Background: Large volume breast reductions are at increased risk of nipple ischemia and necrosis due to tenuous blood supply of long pedicles. We adapted incisional negative pressure wound therapy to augment nipple survival in such patients undergoing mammaplasty by inferior pedicle technique.

Methods: Patients with nipple-to-inframammary fold distance >14 cm were informed of increased risk of requiring free nipple graft. Read More

J Plast Reconstr Aesthet Surg 2021 Oct 17;74(10):2776-2820. Epub 2021 Jun 17.

Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, Agaplesion Markus Hospital, Frankfurt, Germany.

Gland Surg 2021 May;10(5):1840

[This corrects the article DOI: 10.21037/gs-20-440.]. Read More

Eur J Breast Health 2021 Apr 31;17(2):157-164. Epub 2021 Mar 31.

Department of Plastic Surgery, University of Health Sciences Turkey, İstanbul Training and Research Hospital, İstanbul, Turkey.

Objective: This study aimed to investigate whether there was an increase in the number of postoperative complications in patients undergoing reduction mammoplasty depending on the technique used (i.e., pedicle type, skin incision pattern), existence of concomitant diseases, and presence of other risk factors. Read More

Gland Surg 2021 Mar;10(3):1018-1028

Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.

Background: Among breast reduction mammoplasty, the inferior pedicle-based (IFP) technique is considered the most performed by plastic surgeons. A growing interest for the supero-medial based pedicle (SMP) mammoplasty technique has been documented in literature and clinical practice. However, no real evidence exists on the superiority of one technique over another. Read More

Aesthetic Plast Surg 2021 12 5;45(6):2555-2567. Epub 2021 Apr 5.

Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.

Background: Secondary breast reduction is complex and poses significant challenges to surgeons. Complication rates exceed those of primary reduction, commonly caused by impaired vascular supply of the nipple-areolar complex (NAC). Literature on the topic is scare and provides contradicting recommendations, especially with regard to pedicle choice in cases with unknown primary reduction technique. Read More

Aesthet Surg J Open Forum 2020 Jun 16;2(2):ojaa013. Epub 2020 May 16.

Background: There has been an increase in body contouring procedures following massive weight loss (MWL), including male breast reduction procedures. Treating male chest deformity after MWL using standard mastopexy techniques often leads to suboptimal results.

Objectives: The authors describe a technique to treat pseudogynecomastia using a modified elliptical excision and nipple-areola complex (NAC) transposition on a thinned inferior dermal pedicle as an alternative to conventional techniques. Read More

Aesthet Surg J 2021 05;41(6):NP336-NP345

Department of Plastic Surgery, Rigshospitalet, Copenhagen, Denmark.

Background: Reduction mammoplasty effectively improves quality of life for women with macromastia. However, little is known whether surgical- or patient-related factors affect satisfaction.

Objective: The authors sought to investigate factors associated with altered patient satisfaction following reduction mammoplasty. Read More

Aesthetic Plast Surg 2021 04 5;45(2):451-452. Epub 2021 Feb 5.

ProEstetica Medical Center, str. Paris 40 A, sector 1, 011817, Bucharest, Romania.

J Plast Reconstr Aesthet Surg 2021 07 26;74(7):1633-1701. Epub 2020 Dec 26.

Plastic, Reconstructive and Aesthetic Surgery, Department of Mersin University, Medical Faculty, Mersin, Turkey. Electronic address:

Ann Med Surg (Lond) 2020 Dec 22;60:600-603. Epub 2020 Nov 22.

Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.

Introduction: Most of patients undergo reduction mammaplasty for aesthetic or therapeutic reasons without consider the effect on breastfeeding function. Vertical scar mammaplasty with superior pedicle is expected to be a breast reduction procedure that can keep maintain the function of breastfeeding. This is the first recorded report of breastfeeding after vertical scar reduction mammaplasty with superior pedicle in Indonesia. Read More

Gland Surg 2020 Oct;9(5):1590-1595

Breast Surgery Unit, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy.

Breast oncoplastic techniques followed by radiotherapy represent nowadays the standard of care for breast cancer treatment. For tumours located at the upper outer quadrant in patients with large and ptotic breasts, the use of level II breast reduction mammoplasty, allows large quadrantectomies without compromising the breast natural shape and reducing the breast volume to be irradiated. When the skin overlying the tumour in the upper outer quadrant is involved, the removal of the skin during mammoplasty could lead to an extreme reduction of the breast, resulting in a bad outcome. Read More

J Plast Reconstr Aesthet Surg 2021 03 20;74(3):495-503. Epub 2020 Sep 20.

Division of Plastic and Reconstructive Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. Electronic address:

Background: Free nipple grafting indications in breast reduction surgery are outdated. Safety of inferior pedicle technique for large resections and long pedicles has not been clearly defined. We evaluated patients who underwent inferior pedicle reduction mammoplasty to define the safety constraints of the inferior pedicle. Read More

Aesthetic Plast Surg 2021 04 22;45(2):375-385. Epub 2020 Sep 22.

Department of Plastic and Reconstructive Surgery, Affiliated with the Sackler Faculty of Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel.

Background: Reduction mammoplasty in patients with gigantic breast hypertrophy runs a high risk of complication. Traditionally, inferior pedicle reductions or free nipple grafting techniques have been recommended for gigantic breasts on the basis of measurements and expected resection weights. The superiomedial pedicle (SMP) technique has been less commonly used, due to concerns of vascular inadequacy. Read More

Plast Reconstr Surg Glob Open 2020 Jun 23;8(6):e2940. Epub 2020 Jun 23.

Division of Surgical Oncology, Cedars-Sinai Medical Center, Los Angeles, Calif.

Background: Patients with macromastia or breast ptosis can undergo a nipple-sparing mastectomy if their mastectomy flaps are delayed or if they are subjected to a breast reduction procedure and later undergo mastectomy.

Methods: In this report, we describe a new technique to combine these two approaches by initially performing a subtotal mastectomy through a Wise keyhole incision in combination with the retention of the nipple -areolar complex on an inferior pedicle flap. A tissue expander and an allograft are routinely placed during this first stage. Read More

Aesthetic Plast Surg 2021 04 15;45(2):442-450. Epub 2020 Jul 15.

Department of Plastic, Reconstructive and Aesthetic Surgery, Karaman State Hospital, Universite Mahallesi 1984 Str. Number 1, 70200, Karaman, Turkey.

The idea of infiltrating epinephrine-containing solution in reduction mammoplasty with the aim of reducing blood loss dates back to 1985. Although its use is fairly common among surgeons, scientific evidence supporting such use has been feeble and inconsistent. Therefore, we aimed to investigate the effects of tumescent infiltration of lidocaine- and epinephrine-containing solution on blood loss in reduction mammoplasty. Read More

Turk J Med Sci 2020 06 23;50(4):817-823. Epub 2020 Jun 23.

Plastic, Reconstructive, and Aesthetic Surgery, School of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey

Background/aim: Symptomatic breast hypertrophy has a significant impact on the quality of life of women. The amount of tissue to be excised may be preoperatively estimated by an experienced surgeon. However, this remains a subjective assessment. Read More

Aesthet Surg J 2020 11;40(12):NP666-NP675

Background: Breast reduction for extreme macromastia in obese patients is a potentially high-risk endeavor. Free nipple grafting as well as a variety of pedicled techniques have been advocated for large reductions in obese patients, but the number of different approaches suggests that no single method is ideal. This paper suggests the Robertson Mammaplasty, an inferior pedicle technique characterized by a curvilinear skin extension onto the pedicle, as a potentially favorable approach to this clinical situation. Read More

J Plast Reconstr Aesthet Surg 2020 May 11;73(5):876-884. Epub 2019 Dec 11.

Department of Obstetrics and Gynecology, Medical University of Vienna, Währinger Gürtel 18-22, 1090 Vienna, Austria.

Background: Dermis suspensions (DM) have been introduced in reduction mammaplasties (RM) to extend the durability of the results and improve the quality of the scar. The authors present a new method of RM that consists of completing the B-method of Regnault with a well-vascularized DM.

Objective: Analyze the efficacy of a reduction mammaplasty technique proposed by the authors. Read More

Aesthetic Plast Surg 2020 06 3;44(3):689-697. Epub 2020 Mar 3.

Division of Plastic Surgery, Sant'Andrea Hospital, NESMOS Department, School of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.

Background: The aim of the study was to describe details of surgical techniques and objectively evaluate nipple-areola (NAC) sensibility and viability of septum-based mammaplasties compared to not septum-based reduction techniques.

Methods: Data regarding NAC sensibility for static and moving one- and two-point discrimination were prospectively collected from 63 active group hypertrophic-breasted patients undergoing septum-based reduction mammaplasty preoperatively, at 6 and 12 months postoperatively, and from a control group of 60 patients who underwent not septum-based techniques. Fixed and mixed effect models were used for statistical analysis. Read More

Plast Reconstr Surg Glob Open 2019 Dec 31;7(12):e2516. Epub 2019 Dec 31.

Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa.

Background: Reduction mammaplasty was shown to ameliorate physical and psychological problems in adolescents suffering from macromastia. However, benefits of the Wise compared to the vertical incision pattern have not yet been established in this population. The aim of this study is to compare the outcomes of these 2 techniques in adolescents undergoing reduction mammaplasty. Read More

J Reconstr Microsurg 2020 Jun 30;36(5):325-338. Epub 2020 Jan 30.

Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Background:  Advancements in three-dimensional (3D) printing have enabled production of patient-specific guides to aid perforator mapping and pedicle dissection during abdominal flap harvest. We present our early experience using this tool to navigate deep inferior epigastric artery (DIEA) topography and evaluate its impact on operative efficiency and clinical outcomes.

Patients And Methods:  Between January 2013 and December 2018, a total of 50 women underwent computed tomographic angiography (CTA)-guided perforator mapping prior to abdominal flap breast reconstruction, with ( = 9) and without ( = 41) 3D-printed vascular modeling (3DVM). Read More

Plast Reconstr Surg Glob Open 2019 Jul 26;7(7):e2309. Epub 2019 Jul 26.

Department of Reconstructive and Hand Surgery, Azienda Ospedali Riuniti, Ancona, Italy.

Oncoplastic breast reduction shares similar aims and principles with esthetic surgery. Superomedial breast reduction provides harmony, symmetry, and satisfactory lower pole projection, but long-term outcomes are not consistently good. We describe our experience with a new hammock-shaped flap, which was combined with superomedial pedicle breast reduction to improve long-term outcomes by enhancing pedicle support and preventing ptosis recurrence. Read More

Aesthet Surg J 2020 09;40(10):1080-1095

Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background: Many techniques have been introduced for reduction mammaplasty and are utilized in diverse frequencies by different surgeons according to patient needs. Each technique is evaluated based on the aesthetic result, longevity, complication rate, and preservation of the nipple-areola complex (NAC) sensation.

Objectives: The authors sought to introduce the new modified technique of supero-septum pedicle mammaplasty (SSPM) that utilizes both the septum and superior pedicle and is suitable for macromastia and gigantomastia cases. Read More

J Plast Reconstr Aesthet Surg 2020 Mar 5;73(3):486-493. Epub 2019 Oct 5.

Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Croatia; Faculty of Medicine, University of Zagreb, Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital "Dubrava", Zagreb, Croatia.

"Direct to implant," "one-stage," or "immediate" breast reconstruction procedures have become extremely popular in the last decade. The additional task of covering the lower pole of the prosthetic implant for stability can be achieved by one of two principal methods: either the use of acellular dermal matrix (ADM) or alternatively by the use of autologous dermis (inferiorly based dermal flap). In 2013, we published a modification of the inferior pedicle technique for reduction mammaplasty with the principal goal of making a strong, durable, and internalized ``dermal cage'' fixed to the chest wall to support the remaining breast tissue and to prevent the long-term descent of the breast tissue through the effects of gravity. Read More