Goals/Purpose: Breast reduction techniques should aim to achieve “ideal breast shape” and to our knowledge no studies have well defined, with accurate measurements, its morphometric changes. Our goal is to compare the inverted T inferior pedicle and the “Yin-Yang” techniques and to evaluate which best achieves the “ideal breast shape”.
Methods/Technique: 1175 inverted T and 89 Yin-Yang techniques have been performed in the last 5 years by five Authors. Our study prospectively analyzes 30 patients divided in two groups: 1) 15 patients who underwent the inferior pedicle inverted T technique and 2) 15 patients with the Yin-Yang technique. The Yin-Yang procedure uses the principles of gland remodeling characterized by the following: A) superomedial pedicle for the nipple, B) glandular resection pattern with an S-shape on the right breast and mirrored S-shape on the left breast, C) laterally based inferior pole dermoglandular flap. The movement and interdigitation of the two flaps narrows the mammary base, stabilizes the lower pole and enhances nipple projection. D) Scar length and T-junction tension are minimized by resecting skin excess via tailor-tacking.
Patients were selected for BMI, grade of hypertrophy and mastopexies were not included. Morphometric analysis was performed collecting mammary base width, nipple projection, NAC position, nipple-IMF distance. Photographic documentation with overlapping images was taken before and at patient follow up at 2 weeks, 3, 6 months, and 1 year.
Results/Complications: Similar complication rates and nipple sensation findings were detected between the two techniques. Analysis of the morphometric changes showed statistical significance for base width (p value<0.05) and a trend toward significance for projection (p=0.16)
Conclusion: The Yin-Yang technique best achieves breast base narrowing and nipple projection while decreasing scar length and tension. The statistical significance in mammary base width (p<0.05) shows the Yin-Yang technique to be most effective in achieving the "ideal breast shape".
