Breast Reduction: The Superolateral Dermoglandular Pedicle Revisited.

Area of Science:

• Plastic Surgery
• Surgical Techniques
• Breast Surgery

Background:

• Breast hypertrophy with ptosis causes psychological distress and physical pain (neck, shoulder, back).
• Reduction mammaplasty is a common cosmetic procedure improving musculoskeletal symptoms, patient satisfaction, and self-esteem.
• Various breast reduction techniques exist, lacking clear evidence favoring one over another.

Purpose of the Study:

• To evaluate the efficacy and safety of the superolateral pedicle technique for breast reduction.
• To assess its adaptability for augmentation-mastopexy in post-bariatric surgery patients.
• To highlight the technique's benefits in recruiting lateral breast tissue and correcting axillary fullness.

Main Methods:

• Review of 726 patients undergoing breast reduction with a superolateral pedicle over 40 years.
• Adaptation of the technique for simultaneous augmentation-mastopexy in the last 10 years.
• Analysis of outcomes including resection weight, nipple-to-sternal notch distance, follow-up duration, and complication rates.

Main Results:

• Data from 397 patients showed resection weights from 380-1248g and mean sternal notch-nipple distance of 25.3cm.
• Mean follow-up was 22 months with low complication rates: partial nipple-areola complex loss (4), dehiscence (14), hematomas (3), superficial infections (7).
• Nipple sensitivity decreased in 8 patients; 3 were unable to breastfeed; 14 requested revision surgery.

Conclusions:

• Superolateral dermoglandular flap breast reduction is easy, versatile, safe, and effective.
• It preserves physiological functions and is an excellent option for medium-to-large breasts.
• The technique offers benefits like upper pole fullness and correction of axillary fullness.