Reduction mammoplasty: Borrowing the good points of many techniques

The purposes of the reduction mammoplasty are: (a) relief of the pain and discomfort of heavy, pendulous breasts; (b) a normal and pleasing appearance with the brassiere in place and the patient clothed; (c) a reasonable, pleasing contour to the breasts, from front and side, without the support of clothing or brassiere; (d) normally sensitive nipples that become erect on stimulation; (e) minimal apparent permanent scarring; (f) ideally, intact ducts to the nipple; (g) a breast of size allowing for examination for breast masses; (h) eradication of breast masses; (i) a happy patient.Certain circumstances-such as the presence of considerable amounts of diseased breast tissue, scars from resections of lesions of the breasts or from trauma, and massive hypertrophy of the breasts which may dictate a technique requiring free tranplantation of nipples and areolae-understandably may forestall achievement of some of these objectives. However, several of the recent techniques allow the surgeon to achieve these goals in a large percentage of cases. A combination of the better aspects of these techniques, with minor variations, may allow the surgeon to deal even better and more consistently with the problem. The author's technique evolved from the salient points of other techniques he considered desirable enough to borrow.