The reduction mammaplasty--a combined technique.

The purposes of the reduction mammaplasty are: (1) the relief of the pain and discomfort of heavy, pendulous breasts; (2) the reduction is size of the breasts to achieve a normal and pleasing result with the brassiere in place and with clothing; (3) a reasonable and pleasing contour of the breasts from front and side, without the support of clothing or brassiere; (4) normally sensitive nipples which become erect on stimulation; (5) minimal apparent permanent scarring; (6) ideally intact ducts to the nipple; (7) a breast of size allowing for examination for breast masses. It is understandable that certain circumstances may forestall the achievement of some of these objectives, 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 transplantation of nipples and areolae. However, several of the recent techniques allow for the achievements of these goals in a large percentage of cases. A combination of the better aspects of the techniques, with minor variations, may serve to deal even better and more consistently with the problem.