Tailored infolding pattern (T.I.P.) procedure in reduction mammaplasty

This study was performed to determine whether an improved conical breast shape could be consistently accomplished without lower pole flattening, boxiness, or residual lower pole ptosis. Patients were evaluated before the surgery, at which time the true and ideal clavicle-to-nipple distances were measured. The tailored infolding pattern (T.I.P.) procedure, wedge base resection, or a combination of these two new techniques were used for breast reductions in 43 patients. In seven of the 50 patients, free nipple grafts were used. The average age of the patients was 37 years, and 16% were smokers. One patient had diabetes. The average change in true to ideal clavicle-to-nipple distances was 7.5 cm in those in whom the new techniques were used. Up to 1310 gm was resected with the T.I.P. procedure. Two of the 50 patients experienced complications; one occurred in a patient with a history of smoking and the other in the only diabetic patient. The goals of creating lighter breasts with an aesthetically pleasing breast shape and without residual lower pole ptosis or flattening were achieved with the use of the T.I.P. procedure, inferior base wedge resection, or a combination of these two techniques. The T.I.P. procedure is an easily adaptable technique that can be appreciated on the operating room table, thus avoiding a delay of weeks to months to achieve naturally shaped conical breasts. Immediate and long-term results are excellent, with a lower-than-average hypertrophic scar formation rate.