Goals/Purpose: Classically, the vertical style reduction mammoplasty utilizing a superomedial pedicle has been limited to smaller reductions secondary to concerns for poor wound healing and nipple necrosis. The purpose of this study is to review a large cohort of patients who underwent a vertical style superomedial pedicle reduction mammoplasty in an attempt to demonstrate its safety and efficacy in treating symptomatic macromastia.
Methods/Technique: A total of 290 patients (558 breasts) who underwent a vertical style superomedial pedicle reduction mammoplasty were reviewed. All procedures were performed by one of four plastic surgeons over the study period of 6 years.
Results/Complications: The average sternal notch to nipple distance, nipple to inframammary fold distance and base width was 30.8 cm (19-47 cm), 14.8 cm (7-27 cm) and 17.45 cm (12-26 cm), respectively. Over thirty percent (32.6%) of patients exhibited grade III ptosis. The average resection amount was 551.7 grams (176-1827 g) with 4.6% of resections greater than 1000 grams. The total complication rate was 22.7% with superficial dehiscence (8.8%) and hypertrophic scarring (8.8%) comprising the majority. Nipple sensory changes occurred in 1.6% of breasts with no episodes of nipple necrosis. The revision rate was 2.2%. As the resection volume and nipple to fold distance increased so did complication rates, p = .000 and .022 respectively.
Conclusion: The vertical style superomedial pedicle reduction mammoplasty, while traditionally being limited to moderate sized reductions, is safe and effective for a wide range of symptomatic macromastia. The nipple-areola complex can be safely transposed even in larger degrees of macromastia with no episodes of nipple necrosis. Revision rates are low indicating high patient satisfaction. Complication rates are acceptable, however, as resection volumes increase so did wound healing issues. Surgeons should be aware of these limitations and take preventative measures when treating larger degrees of symptomatic macromastia
