Breast reduction: Inferior pedicle, wise pattern

2015 ◽  
pp. 51-58
Author(s):  
TARIK HUSAIN ◽  
SETH THALLER
Keyword(s):  
Breast Reduction ◽  
Inferior Pedicle ◽  
Wise Pattern

scholarly journals The expanded inframammary fold triangle: Improved results in large volume breast reductions

2014 ◽  
Vol 47 (01) ◽  
pp. 65-69 ◽  
Author(s):  
Karan Chopra ◽  
Kashyap Komarraju Tadisina ◽  
Alexandra Conde-Green ◽  
Devinder P Singh
Keyword(s):  
High Risk ◽  
Large Volume ◽  
Breast Reduction ◽  
Reduction Mammaplasty ◽  
Inframammary Fold ◽  
Wound Complications ◽  
Obese Patients ◽  
Inferior Pedicle ◽  
Improved Outcomes ◽  
Wise Pattern

ABSTRACT Context: The inferior pedicle, Wise-pattern reduction mammaplasty is the most popular technique for breast reduction because of its reproducible results and reliability. However, complication rates in super obese patients or patients receiving large volume reductions are high, ranging from 35 to 78%. These complications include delayed healing, infection, seroma, nipple-areolar complex necrosis, fat necrosis and development of hypertrophic scars. Aims: This study aimed to determine whether a modification to the standard Wise-pattern reduction technique, an expanded inframammary fold skin triangle, produces improved outcomes in high-risk large volume breast reduction patients. We report that this modification leads to improved outcomes by decreasing wound complications and improving aesthetic appearance. Settings and Design: Twenty-two patients received the inferior pedicle Wise-pattern reduction mammaplasty, which was modified to include an 8 cm wide inferior pedicle. This pedicle was de-epithelialized and an 8 Χ 3 cm 2 triangle of skin was preserved at the inferior base to reduce tension at the triple point, inverted T-closure. Materials and Methods: A retrospective review was performed on all patients who underwent reduction mammaplasty with the expanded inframammary fold (eIMF) technique as well as all patients who received the standard wise pattern technique. Statistical Analysis Used: A student t-test was performed for both reduction populations using SPSS software package. Statistical significance was defined as P < 0.05. Results: The average patient age was 32.25 years old (range 18-59), average BMI was 35.0, and average tissue mass removed per breast was 1378.39 g. The modified technique was found to produce a statistically significant (P < 0.05) increase in the amount of breast tissue removed (693.96 g increase in the left and 571.21 g in the right) as well as a statistically significant (P < 0.05) reduction in dehiscence (75% reduction) and post-operative infection (44.10%). Conclusions: This method is an easily reproducible and reliable technique that produces a favourable cosmetic outcome with acceptable, sustainable results in high-risk reductions in obese patients.

scholarly journals Management of Recurrent Symptomatic Macromastia: A Single Surgeon’s Experience

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Ali A Qureshi ◽  
W Grant Stevens
Keyword(s):  
Complication Rate ◽  
Breast Reduction ◽  
Long Term Results ◽  
Inferior Pedicle ◽  
Billing Data ◽  
Level Of Evidence ◽  
Areola Complex ◽  
Areolar Complex ◽  
Increased Risk ◽  
Wise Pattern

Abstract Background Breast reduction for symptomatic macromastia can have excellent long-term results and relief of symptoms. However, patients may require a re-reduction for recurrent symptoms. Previous reports of re-reduction after a primary inferior pedicle reduction have called into question the safety of blood supply to the nipple-areola complex with re-reduction. Objectives To examine a single surgeon’s experience and management of recurrent symptomatic macromastia after inferior pedicle breast reduction. Methods A retrospective review was performed of a single surgeon’s breast reduction experience using billing data to identify cases of breast re-reduction from January 2003 and January 2018. Breast re-reduction was performed either with a Wise pattern, inferior pedicle or with a smile reduction with an inferior pedicle. Liposuction was used in re-reductions only. Results In 15 years, 3530 breast reductions were performed in 1758 patients. In 7 patients, 14 total re-reductions were performed, including 13 secondary breast re-reductions (12 bilateral, 1 unilateral) and 1 tertiary, unilateral breast re-reduction. Seven Wise pattern, inferior pedicle and 7 smile reductions with inferior pedicle procedures were done at the breast level. This translates to a re-reduction incidence of 1 in 250 or 0.4% rate of re-reduction at the patient level in our practice. The minor complication rate was 14% (1 seroma), and the major complication rate was 0%. There were no instances of partial or complete nipple areola necrosis. Conclusions Recurrent symptomatic macromastia can be managed with re-reduction with re-creation of the inferior pedicle or a smile breast reduction as we describe without increased risk to nipple-areolar complex viability. Level of Evidence: 4

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