Treatment of large and ptotic breasts

The breasts have always been considered a sign of femininity. The correction of breast deformities is therefore important from a physical and psychological point of view, improving greatly the quality of life. Many surgical techniques have been proposed to correct the shape and volume of the breast, and in recent decades techniques have been proposed to preserve the nipple sensitivity and increase the vascular safety of the procedure. Templates (such as the Wise pattern) have been proposed to improve planning and different pedicles for the areola have been described. During the last 20 years, new techniques have been introduced to minimize scars, leaving normal sensitivity in almost all cases, the possibility of lactation, and a pleasing shape. The periareolar scar is, unfortunately, always necessary to reposition the nipple–areolar complex. The vertical scar is necessary to resect the excess of skin of the lower pole of the breast. Effort has been directed to reduce or eliminate the horizontal submammary scar, leading to a vertical scar only, even in large reductions.