Central pedicle reduction mammaplasty with a vertical scar: a technical modification.

[BACKGROUND] This study introduces a central pedicle reduction mammaplasty with a vertical scar technique.

[OBJECTIVES] This study is aimed to create a more conical breast shape and long-lasting better projection by modifying reduction mammaplasty by central pedicle flap.

[METHOD] Preoperative markings were made including the meridian line of breast and the new location of the nipple-areola complex (NAC). The new location of the inframammary fold was marked ∼2 ∼ 4 cm above the original inframammary fold. An incision was made around the areola, the area between the resection margins and NAC was excised en bloc. The breast parenchyma was excised circumferentially, so that a cone shaped central mound was formed. An inferior and inferolateral glandular resection was performed to reduce the area of the breast base by elevating the position of the inframammary fold. After completion of dissection, the central pedicle surmounted by the NAC was transposed to its new location.

[RESULT] Fifty-six patients were operated with our modified central pedicle technique. The mean amount of resection was 475 g (range = 130-1080 g). The mean length of follow-up was 18 months (range = 12-53 months). The mean postoperative satisfaction score was 4.23 (SD = 0.81). The breast parenchymal ratio significantly increased from 1.2 preoperatively to 3.9 postoperatively.

[CONCLUSION] The modified central pedicle reduction mammaplasty with a vertical scar technique is a versatile breast reduction technique for all shapes and tissue conditions, by providing an attractive conical shape of the breast with minimum scar burden and maximum preservation of breast function.