Improving the Aesthetic Outcome of the Superomedial Pedicle in Wise-Pattern Breast Reduction Using a Suspension “Hammock” Flap Technique

Abstract

Background: Superomedial pedicle reduction mammoplasty provides satisfactory and symmetrical projection of the lower pole. Its satisfactory outcome cannot be preserved consistently for quite some time. This study describes the combination of superomedial pedicle breast reduction with the "Hammock" flap suspension sling to obtain a satisfactory long-term outcome through pedicle support enhancement and preventing pseudoptosis.Objective: This study aimed to assess the aesthetic outcome and the possible complications of superomedial pedicle in wise pattern reduction mammoplasty combined with a suspension hammock-flap for additional fixation and stabilisation of the pedicle and to improve the contour and projection of the lower pole.Methods: Fifteen patients with breast hypertrophy eligible for breast reduction were operated on using a combined superomedial pedicle reduction mammoplasty with a perforator-based inferior advancement "Hammock" flap. The "Hammock flap" fixed to the fascia of pectoralis major muscle and the superomedial pedicle as a hammock. Breast measurements were recorded preoperatively and postoperatively (1, 6, and 12 months). Patients reported their own satisfaction with breast volume, contour, position of the nipple-areola complex (NAC), and projection of the lower pole at the end of the follow-up period through the BREAST-Q Version 2.0 "Reduction/Mastopexy Module Pre-and Postoperative Scales questionnaire". Results: Aesthetic outcomes at one-year post-operative were satisfactory in almost all patients, as indicated by BREAST-Q scores, with a low incidence of complication rates. Furthermore, the postoperative breast measurements were nearly constant during the follow-up period. Conclusion:Hammock flap sling technique, which is performed through an inferior dermo glandular flap, is an approach that is effective and safe approach that can improve pedicle fixation and positioning. Furthermore, it results in a favorable long-term aesthetic outcome for patients undergoing superomedial pedicle reduction mammoplasty.