TITLE:
The Combination of Three Techniques for Breast Reduction: A Series of Ten Consecutive Cases
AUTHORS:
Alessandro Borgognone
KEYWORDS:
Breast Reduction, Skin Reduction, Gland Reduction, “Foustanos” Flap, Nipple Areolar Complex Shaping
JOURNAL NAME:
Modern Plastic Surgery,
Vol.4 No.3,
July
30,
2014
ABSTRACT: There is continuing
controversy regarding the most effective and safest technique for breast
reduction surgery. This case series describes our experience with a breast
reduction approach that combines three techniques aimed at addressing three
different aspects of breast reduction: skin reduction, shaping, and nipple
areolar complex shaping. We assessed the perioperative course and postoperative
outcomes (for a mean of 19 months) of 10 consecutive women who underwent breast
reduction surgery involving a combination of three techniques: “inverted T”
skin reduction, modified Hall-Findley supero-medial pedicle for glandular
reduction, and inferior de-epithelialized flap (modified “Foustanos” flap) for
molding and improved shaping of the breast. The final bra cup size was C or D
in all patients. The overall results were graded as excellent in four patients
and very good in six patients. Each patient was completely satisfied with her
surgery. Six patients developed venous congestion of the nipple areolar
complex, which resolved within 24 - 48 hours after surgery. Two patients had
uneventful delayed wound healing in the vertical scar of the inverted T
pattern. There was a 100% nipple areolar complex survival rate. No patient had
a major adverse event, permanently altered nipple areolar complex sensitivity,
or bottoming out of the lower pole. None required revision surgery. This case
series confirms our expectations that the solution to questions about breast
reduction methods may depend on melding different techniques into a single
procedure. The combination of techniques herein described was both effective
and safe. Level of Evidence: Level IV, therapeutic study.