Unfavorable Outcomes With Vertical Reduction Mammaplasty: Part II

Adham, Mehdi N.; Sawan, Kamal; Lovelace, Candis; Jaeger, Nolan J.; Adham, Christine

doi:10.1177/1090820x10390757

Cited by 20 publications

(11 citation statements)

References 13 publications

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“…The complication of nipple necrosis in breast reduction and mastopexy procedures has been reported in the literature to range up to 2.1% for complete NAC necrosis and 7.3% for partial NAC necrosis with a superior dermal/vertical scar [4]. Another study of 260 patients who underwent vertical reduction mammaplasty resulted in three patients with partial nipple loss due to significant excision [5]. Risk factors for these complications include obesity, diabetes, past history of poor wound healing, heavy smoking, simultaneous augmentation and mastopexy, previous radiation/chemotherapy, steroid use, previous scars around the NAC, post-bariatric surgery malnutrition, genetic predisposition to thrombosis, malignancy, and/or having large breasts as these may strain the blood supply further, which can ultimately lead to a higher rate of nipple necrosis postoperatively [6,7].…”

Section: Discussionmentioning

confidence: 99%

Healing of Bilateral Nipple Areolar Complex Necrosis by Secondary Intention

Vazquez

Becker

2020

Cureus

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Complete necrosis of the nipple, areola, or both is a uncommon complication of reduction mammaplasty, especially if it happens bilaterally. This case involving a young, black female illustrates that, in a large open wound of the breast, it would be ideal to leave it to heal by secondary intention as adding a skin graft would only speed up the healing process and not improve the result with the additional risk of keloid at the donor site. This open wound of the breast was treated with progressive surgical debridement while assessing the affected area in order to preserve as much tissue as possible due to the sensitive nature of the wound along with wet to dry dressing changes and antibiotic solution treatment. Our report suggests an additional approach to the standard of care involving a free flap to improve aesthetic outcomes.

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Section: Discussionmentioning

confidence: 99%

Healing of Bilateral Nipple Areolar Complex Necrosis by Secondary Intention

Vazquez

Becker

2020

Cureus

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“…Complications after vertical scar techniques represent a spectrum of severity from issues requiring conservative management to conditions requiring hospitalization and surgery [19].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study between Superior Pedicle (Modified Lejour) and Medial Pedicle (Findlay) Reduction Mammoplasty Technique from the Aesthetic Point of View

Din

SHerbeny

Mahmoud

et al. 2019

The Egyptian Journal of Plastic and Reconstructive Surgery

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Background: There are significant changes in breast shape and contour during the 1 st post-operative year after any breast reduction technique. Our work was dedicated to study the post-operative changes and aesthetic outcome in the superior and medial pedicle vertical scar reduction mammoplasty techniques. Patients and Methods:The study was conducted on 20 female patients suffering from bilateral large breasts. They were divided equally into two groups using simple randomization. Group I (10 patients) were operated upon by superior pedicle (modified Le Jour) technique. Group II (10) patients were operated upon by medial pedicle (hall-findlay) technique. Patients were evaluated for esthetic outcomes. This was done through breast measurements and photographic analysis preoperatively, 1, 3 and 6 months post-operatively. Results:There is no significant difference between group I and group II regarding the pre-operative measurements and intra-operative scar length. However, a significant difference was present between both groups for all measurements except IMF level at 3 and 6 months post-operatively. There is no significant difference in the photographic analysis.Conclusion: Both techniques are aesthetically reliable with more bottoming out in findlay technique. Lower pole show is less in modified Lejour technique. Also, two new breast measurements were introduced.

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“…4,8,9 It has been the author's experience that the patient selection can be the first critical element to ensure the success of such an operation. The author believes that unlike that described by others, 1Y3,10,11 the medial pedicle vertical breast reduction can only be indicated for certain patients who are relatively at a younger age but most importantly with a good skin condition of the breasts.…”

Section: Discussionmentioning

confidence: 99%

“…7 The management of complications is also critical to ensure an optimal outcome after the medial pedicle vertical breast reduction. 6,8 In the author's practice, the delayed wound healing in the skin purse string area may occur in about 20% of the patients. The management of these minor wounds would require more patient reassurance and prolonged local wound care.…”

Section: Discussionmentioning

confidence: 99%

Achieving an Optimal Outcome for Medial Pedicle Vertical Breast Reduction

2014

Annals of Plastic Surgery

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Breast reduction is a common procedure performed by plastic surgeons for functional or cosmetic improvement of the breast. However, final outcome can be less satisfactory to patients in terms of the size, shape, symmetry, scarring, or wound healing complications. However, good to excellent outcome after breast reduction can be accomplished by plastic surgeons once they have mastered their technique. The medial pedicle vertical breast reduction has been popularized recently. However, the technique is technically more complex, and the results have been less inconsistent with a learning curve. In addition, the technique has been criticized for a residual deformity in the lower pole of the breast and resulted in a high revision rate. In this article, key components for the medial pedicle vertical breast reduction including patient selection and technical refinements are discussed in details. The author describes his philosophy in patient selection, preoperative and intraoperative markings of the breast, and step-by-step surgical procedures with several technical refinements for the medical pedicle vertical breast reduction. In addition, the pearls for achieving an optimal outcome of such a breast reduction are also discussed.

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Unfavorable Outcomes With Vertical Reduction Mammaplasty: Part II

Cited by 20 publications

References 13 publications

Healing of Bilateral Nipple Areolar Complex Necrosis by Secondary Intention

Healing of Bilateral Nipple Areolar Complex Necrosis by Secondary Intention

A Comparative Study between Superior Pedicle (Modified Lejour) and Medial Pedicle (Findlay) Reduction Mammoplasty Technique from the Aesthetic Point of View

Achieving an Optimal Outcome for Medial Pedicle Vertical Breast Reduction

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