Document Detail

Lowering revision rates in medial pedicle breast reduction by the selective addition of "inverted-T" technique.
MedLine Citation:
PMID:  23358581     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The superomedial pedicle vertical-scar breast reduction is an effective technique, but high revision rates have been reported. The purpose of this study is to determine if revision rates can be lowered by the rational use of an inverted-T technique in a subset of patients who undergo superomedial pedicle reduction.
METHODS: Records were reviewed of 127 breast reductions performed between 2002 and 2011. Group 1 (2002-2007) consisted of 51 patients who underwent a superomedial pedicle vertical-scar reduction. Four of these patients (8%) required a subsequent revision. Based on this, indications were adopted where vertical-scar reductions were performed in patients with proposed nipple position to inframammary fold (PNP-IMF) distances of less than 22 cm, with the remainder undergoing reduction with a superomedial pedicle and inverted-T skin resection pattern. In Group 2 (2008-2011), there were 41 vertical reductions and 35 "hybrid" reductions. Age, BMI, preoperative medical conditions, and reduction size did not differ significantly between the two groups.
RESULTS: Nine patients in Group 1 (18%) experienced one or more minor complications, as did 12 patients in Group 2 (16%), (p=0.62). There were four revisions in Group 1 (8%) and none in Group 2 (p<0.001). Mean operative time was 177 min in Group 1 compared to 136 min in Group 2 (p<0.001).
CONCLUSIONS: Breast reduction employing a superomedial pedicle can be used effectively in a wide range of patients. Revision rates can be reduced by employing an inverted-T skin resection in patients with a long PNP-IMF distance, while not significantly increasing complication rates or operative time.
LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors .
Brian Rinker
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2013-01-29
Journal Detail:
Title:  Aesthetic plastic surgery     Volume:  37     ISSN:  1432-5241     ISO Abbreviation:  Aesthetic Plast Surg     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-26     Completed Date:  2013-09-19     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  7701756     Medline TA:  Aesthetic Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  341-8     Citation Subset:  IM    
Division of Plastic Surgery, Department of Surgery, University of Kentucky, Kentucky Clinic, Lexington, KY 40536, USA.
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MeSH Terms
Breast / abnormalities,  pathology*,  surgery*
Cicatrix / prevention & control
Cohort Studies
Follow-Up Studies
Hypertrophy / surgery
Mammaplasty / adverse effects,  methods*
Middle Aged
Postoperative Complications / surgery
Reoperation / statistics & numerical data
Retrospective Studies
Risk Assessment
Suture Techniques*
Wound Healing / physiology
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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