Pedicles in vertical breast reduction and mastopexy.

Any pedicle can be used to achieve a good breast reduction. We need to look at the skin pattern as separate from the pedicle design. There are numerous (and good) combinations available. Different situations will determine which combination is preferable. The author performed a standard inferior pedicle Wise pattern technique for the first 11 years of her practice and has now used variations of the vertical technique for the past 8 years. She has personally found that the medial pedicle gives the best breast reduction results in her hands. On the other hand, a lateral pedicle is used for mastopexies so that the inferior and lateral tissue can be rotated up under the areola. When faced with a re-reduction of a previous inferior pedicle, the vertical technique can still be used, and an adaptation of the inferior pedicle can be very acceptable. The superior pedicle is reserved mainly for very small reductions or mastopexies, but the author still finds the medial pedicle allows better lateral resection even in small reductions, and the lateral pedicle with recruitment of tissue allows for some auto-augmentation in mastopexies.