"Reduction mammaplasty with superomedial pedicle technique: A literature review and retrospective analysis of 938 consecutive breast reductions".

Breast reduction Breast reduction weight Complication rate Inferior pedicle Reduction mammaplasty Superomedial pedicle

Journal

Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 05 03 2017
revised: 17 11 2018
accepted: 02 12 2018
pubmed: 24 12 2018
medline: 25 12 2019
entrez: 24 12 2018
Statut: ppublish

Résumé

The superomedial pedicle reduction mammaplasty has been noted in the literature to provide superior aesthetic results and longevity as well as shorter operative times. However, the inferior pedicle continues to be the most commonly utilized technique in the United States. There is a lack of large-volume outcome studies examining how the superomedial pedicle technique compares against more established reduction methods. A retrospective review of 938 reduction mammaplasties was performed at a single institution over a 10-year period. A literature review of superomedial and inferior pedicle complication rates were performed. Study variables were compared against overall mean complication rates for the two techniques. Logistic regression, paired student T-Tests, and Chi-square analyses were used to calculate adjusted odds ratios and to compare continuous and categorical variables. Mean reduction weight was 730 g per breast, ranging from 100 to 4700 g. Overall complication rate was 16%, of which 10% were minor complications related to delayed wound healing. No cases of skin flap necrosis occurred. Increased complications were highly correlated with a BMI > 30, breast reduction weights > 831 g, and sternal notch to nipple distances > 35.5 cm. The superomedial pedicle reduction mammaplasty technique is safe and reliable with a complication rate lower than the inferior pedicle technique. Based on our findings we propose that residents should be exposed to this method of reduction mammaplasty as part of a compilation of techniques learned in residency and that practicing surgeons would benefit from becoming familiar with its applications.

Sections du résumé

BACKGROUND BACKGROUND
The superomedial pedicle reduction mammaplasty has been noted in the literature to provide superior aesthetic results and longevity as well as shorter operative times. However, the inferior pedicle continues to be the most commonly utilized technique in the United States. There is a lack of large-volume outcome studies examining how the superomedial pedicle technique compares against more established reduction methods.
METHODS METHODS
A retrospective review of 938 reduction mammaplasties was performed at a single institution over a 10-year period. A literature review of superomedial and inferior pedicle complication rates were performed. Study variables were compared against overall mean complication rates for the two techniques. Logistic regression, paired student T-Tests, and Chi-square analyses were used to calculate adjusted odds ratios and to compare continuous and categorical variables.
RESULTS RESULTS
Mean reduction weight was 730 g per breast, ranging from 100 to 4700 g. Overall complication rate was 16%, of which 10% were minor complications related to delayed wound healing. No cases of skin flap necrosis occurred. Increased complications were highly correlated with a BMI > 30, breast reduction weights > 831 g, and sternal notch to nipple distances > 35.5 cm.
CONCLUSIONS CONCLUSIONS
The superomedial pedicle reduction mammaplasty technique is safe and reliable with a complication rate lower than the inferior pedicle technique. Based on our findings we propose that residents should be exposed to this method of reduction mammaplasty as part of a compilation of techniques learned in residency and that practicing surgeons would benefit from becoming familiar with its applications.

Identifiants

pubmed: 30579911
pii: S1748-6815(18)30443-1
doi: 10.1016/j.bjps.2018.12.004
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

410-418

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2018. Published by Elsevier Ltd.

Auteurs

Adam J Bauermeister (AJ)

Department of Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, USA. Electronic address: Adam.Bauermeister@erlanger.org.

Kiranjeet Gill (K)

Department of Plastic Surgery, Cleveland Clinic Florida, Weston, FL, USA.

Alexander Zuriarrain (A)

Department of Plastic Surgery, Cleveland Clinic Florida, Weston, FL, USA.

Steven A Earle (SA)

Department of Plastic Surgery, Cleveland Clinic Florida, Weston, FL, USA.

Martin I Newman (MI)

Department of Plastic Surgery, Cleveland Clinic Florida, Weston, FL, USA.

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Classifications MeSH