Semicircular Horizontal Approach in Breast Reduction: Clinical Experience in 38 Cases

Abstract

BackgroundVarious techniques are used for performing breast reduction. Wise-pattern and vertical scar techniques are the most commonly employed approaches. However, a vertical scar in the mid-lower breast is prominent and aesthetically less pleasant. In contrast, a semicircular horizontal approach does not leave a vertical scar in the mid breast and transverse scars can be hidden in the inframammary fold. In this paper, we describe the experiences and results of semicircular horizontal breast reductions performed by a single surgeon.MethodsBetween September 1996 and October 2013, our senior author used this technique in 38 cases in the US and at our institution. We used a superiorly based semicircular incision, where the upper skin paddle was pulled down to the inframammary fold with the nipple-areola complex pulled through the keyhole.ResultsThe average total reduction per breast was 584 g, ranging from 286 to 794 g. The inferior longitudinal pedicle was used in all the cases. The average reduction of the distance from the sternal notch to the nipple was 13 cm (range, 11-15 cm). The mean decrease in the bra cup size was 1.7 cup sizes (range, a decrease of 1 to 3). We obtained very satisfactory results with a less noticeable scar, no complication such as necrosis of the nipple or the skin flap, wound infection, aseptic necrosis of the breast tissue, or wound dehiscence. One patient had a small hematoma that resolved spontaneously.ConclusionsThis technique is straightforward and easy to learn, and offers a safe, effective, and predictable way for treating mammary hypertrophy.

The Passot Technique Revisited: No Vertical Scar Reduction Mammoplasty in Unmarried Females: A Case Series

“…In our study, successful reduction could be done with the mean distance from sternal notch to the areola being 32.8 cm. The result reflects that of a previous study where this technique was used 6 .…”

“…The distance from the nipples to the inframammary fold was kept at 5cm-6 cm (Figure 1). To achieve a minimal areolar scar, the areola was measured at 4 cm-5 cm and the new areola site circle was drawn at 2.5-3.0 cm 6 . The surgery was performed under general anesthesia with the patient in supine position.…”

“…It was not completely raised off the chest wall and a thick column of subareolar parenchyma was preserved 6. The upper skin flap was elevated between the subcutaneous tissue and Scarpa's fascia and its thickness was about 1.5 cm 6 . The breast tissue was then removed as necessary.…”