Reduction Mammaplasty Using Inferior Pedicle Technique Combined With Dermal Suspension

Accordion-style pedicle suspension in inferocentral pedicled mammoplasty

“…Widgerow [3] proposed weaving a rectangular dermal fascia flap prepared on the medial side of the pedicle into the pectoral musculature and fascia. Similar to Aydin et al [14], Menderes et al [17] concurred that in McKissock's vertical bipedicled flap technique, pedicle suspension with two triangular dermal flaps prepared from both sides of the pedicle decreased the occurrence of secondary ptosis in the reduced breasts. The literature lacks clear data regarding pseudoptosis following inferior pedicled breast reduction techniques which rely on pedicle suspension and plication.…”

“…Quan et al [6] reported that pseudoptosis develops most commonly and most rapidly in the first postoperative year and that bottoming out progresses significantly, but mildly, during the following 2 years. Efforts to achieve a sustainable breast mould that will not deform significantly over the long-term have yielded the development of various methods and modifications JOURNAL OF PLASTIC SURGERY AND HAND SURGERY 5 [7][8][9][10][11][12][13][14]. The inferior pedicle technique, which was first introduced four decades ago, remains the most popular technique because of its preservation of sensation and vascularisation of the nipple, especially in patients with a long sternal notch-to-nipple distance [4].…”

“…Drawbacks of the technique include the tendency to develop pseudoptosis (or 'bottoming out'), tedious de-epithelialisation, poor or inadequate projection, upward NAC rotation, and tension at the inverted T-junction. Many modifications have been proposed to alleviate or avoid these issues [2][3][4][5]7,[11][12][13][14][15]. Most of these modifications are based on plication and fixation of the pedicle on the pectoral fascia via dermal flaps extending from it [2,4,7,[13][14][15][16].…”

“…Most of these modifications are based on plication and fixation of the pedicle on the pectoral fascia via dermal flaps extending from it [2,4,7,[13][14][15][16]. Aydin et al [14] proposed suspending the pedicle to the pectoral fascia via two triangular dermal flaps to sustain the breast shape. Widgerow [3] proposed weaving a rectangular dermal fascia flap prepared on the medial side of the pedicle into the pectoral musculature and fascia.…”

The “Dermal Cage”: A Modification of the Inferior Pedicle Breast Reduction

“…Furthermore the technique lacked real "high" suspension. Further modifications of internal dermal suspension had been published by Frey [20], Echo [21], Baumeister [22], Aydin [23] and Rubin [24] for mastopexy after massive weight loss.…”