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Orloff G. Safety and Efficacy of a Central Pedicle Technique for Mastopexy and Mastopexy with Implant Augmentation. Plast Reconstr Surg 2024; 154:70e-78e. [PMID: 37621017 DOI: 10.1097/prs.0000000000011016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
BACKGROUND The central pedicle technique (CPT) is rarely used to perform mastopexy or mastopexy with implant augmentation despite having robust perfusion and allowing for great exposure, resulting in reproducible results. This study was conducted to review one surgeon's experience using the CPT for both mastopexy and mastopexy with implant augmentation. METHOD A retrospective review of consecutive patients who had a mastopexy or mastopexy with augmentation using a standardized CPT from 2017 through 2021 was performed. RESULTS A total of 201 patients were identified for inclusion: 120 had a bilateral central pedicle mastopexy, 75 had bilateral central pedicle mastopexy and implants, and 6 had unilateral central pedicle mastopexy with implants because of asymmetry. Mean follow-up was 11.2 months. The average age was 45.4 years, body mass index 25.1 kg/m², and implant size 275 cc. The overall complication rate was 9.5%: 9.2% for CPT mastopexy and 9.9% for CPT mastopexy with implants. No revisional surgery was requested. None of the patients experienced nipple or skin necrosis. CONCLUSIONS This study demonstrates that CPT mastopexy with or without an implant can be performed safely with a low complication rate. Additional benefits include standardized markings before surgery, visualization of the entire breast mound, and reliable perfusion. The technique excels in correcting asymmetry. CPT mastopexy with or without an implant is a safe and effective option for the treatment of breast ptosis. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- George Orloff
- From Burbank Plastic Surgery and Providence Saint Joseph Medical Center
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La Padula S, Mernier T, Larcher Q, Pizza C, D'Andrea F, Pensato R, Meningaud JP, Hersant B. Superomedial-Posterior Pedicle-Based Reduction Mammaplasty: Evaluation of Effectiveness and BREAST-Q Outcomes of a Rapid and Safer Technique. Aesthetic Plast Surg 2024; 48:2108-2120. [PMID: 37783863 PMCID: PMC11150295 DOI: 10.1007/s00266-023-03676-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION Breast hypertrophy, a common pathological condition, often requires surgical intervention to alleviate musculoskeletal pain and improve patients' quality of life. Various techniques have been developed for breast reduction, each with its own advantages and complications. The primary aim of this study is to evaluate the efficacy, safety, and patient-reported outcomes of the authors technique: the Superomedial-Posterior Pedicle-Based Reduction Mammaplasty. MATERIAL AND METHODS A prospective study was conducted on 912 patients who underwent breast reduction surgery between November 2012 and July 2020. The surgical technique involved preserving all glandular tissue from the areola to the pectoralis major muscle using the superomedial-posterior pedicle. The patients' demographic data, operative details, complications, breast-related quality of life (measured using the Breast-Q questionnaire), and nipple-areola complex sensitivity were analyzed. RESULTS The average operative time was 62.12 ± 10.3 minutes. Complications included minor wound dehiscence (4.05%) and hematoma (1.2%), with no cases of nipple-areola complex necrosis. Nipple-areola sensitivity was fully restored in all patients at the 2-year follow-up. Patient satisfaction with the procedure was high with a statistically significant difference observed between pre- and postoperative scores (p < 0.001) of the Breast-Q questionnaire. CONCLUSION Authors technique offers reliable vascularization and innervation of the nipple-areola complex and achieves satisfactory aesthetic outcomes. It is associated with shorter operative times compared to other techniques reported in the literature. The Superomedial-Posterior Pedicle-Based Reduction Mammaplasty represents a safe and effective method for breast reduction surgery, providing significant benefits to patients with breast hypertrophy. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Simone La Padula
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy.
- , 50 rue Saint Sébastien, 75011, Paris, France.
| | - Thibaud Mernier
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Quentin Larcher
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Chiara Pizza
- Department of Plastic, Reconstructive and Maxillo facial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Francesco D'Andrea
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Rosita Pensato
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Jean Paul Meningaud
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
| | - Barbara Hersant
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131, Napoli, Italy
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Kaplan HY, Rysin R, Shachar Y. The Infero-Central Mound Reduction Mammoplasty: A Single Surgeon, 20-year Experience. Aesthetic Plast Surg 2024; 48:914-924. [PMID: 37380748 DOI: 10.1007/s00266-023-03442-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/27/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Reduction mammoplasty (RM) remains one of the most common plastic surgeries worldwide. Many different techniques have been described in the literature, each with its advantages and limitations. Nipple-areolar complex necrosis remains a daunting complication, regardless of the chosen surgical approach. OBJECTIVE We describe the senior author's (HYK) unique reduction mammoplasty technique, employing the infero-central (IC) pedicle throughout the last two decades. PATIENTS AND METHODS A retrospective chart review of 520 patients undergoing breast reduction was performed. After exclusion criteria, 360 were included in the study. These patients underwent RM with the IC technique, with stabilization of the breast mound and plication of the inferior pole dermis to prevent bottoming out. Demographics, operative data, and complications were recorded. Pre- and postoperative photographs were evaluated by a specialists' panel. The BREAST-Q questionnaire was utilized to assess satisfaction rates. RESULTS BREAST-Q questionnaire-satisfaction with breast score was 84.19, and outcome score was 91.67. Aesthetic outcome evaluation, reviewed by four plastic surgeons, yielded a high score in all parameters (1.64-2; range 0-2). On a per-breast basis for all patients, the following complications were analyzed: dehiscence (3.61%), infection (2.22%), hematoma (1.66%), superficial wound healing problems (1.38%), seroma (0.83%), skin flap ischemia (1.52%), hypertrophic scar (1.38%), fat necrosis (0.97%), and partial nipple ischemia (0.27%). CONCLUSION Infero-central mound technique can be applied to breast reductions of nearly all sizes, allowing for consistently satisfactory aesthetic outcomes for most patients. Due to robust vascularity of the pedicle, complication rates are kept at a minimum. IC mound technique is an essential tool in the plastic surgeon's armamentarium. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Haim Yoel Kaplan
- Department of Plastic Surgery, Yitzhak Shamir Medical Center, 70300, Tzrifin, Israel.
- Private clinic, 10 Dubnov street, 6473209, Tel Aviv, Israel.
| | - Roman Rysin
- Private clinic, 10 Dubnov street, 6473209, Tel Aviv, Israel
| | - Yair Shachar
- Private clinic, 10 Dubnov street, 6473209, Tel Aviv, Israel
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Stocco C, Cazzato V, Renzi N, Manara M, Ramella V, Scomersi S, Fezzi M, Bortul M, Arnez ZM, Papa G. Central Mound Technique in Oncoplastic Surgery: A Valuable Technique to Save Your Bacon. Clin Breast Cancer 2023; 23:e77-e84. [PMID: 36717320 DOI: 10.1016/j.clbc.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/01/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Breast-conserving surgery (BCS) is a valid method for the reconstruction of partial breast defects, however, there is a great variety of final aesthetic outcomes depending on the location of the tumor in the breast and also on the initial breast volume and the degree of ptosis. Specifically, defects affecting the upper inner/central quadrant represent a reconstructive challenge with not always satisfactory final results. For this purpose, the authors investigated the use of the central mound technique in breast-conserving surgery. The aim of the study was to apply the central mound as an oncoplastic technique and assess the satisfaction rate of the patients. MATERIALS AND METHODS This was a retrospective study that involved 40 patients (80 breast) underwent breast conserving surgery and contextual bilateral breast remodeling with central mound technique. A pre- and postoperative Breast-Q questionnaire (breast conserving therapy module) was given to all the patients before the surgery, 3 months and 9 months after. The statistical analysis with chi-square test was performed. RESULTS After 9 months the author found a major increase of all BREAST-Q parameters; the most valuable increments concerned the "Satisfaction with breast" and "Psychosocial well-being." None of the patients experienced a decreased in the quality of life related to the surgical procedure. CONCLUSION The authors believe that this technique has useful functional and aesthetic results particularly appreciated by patients with upper pole lesion who have a slightly or moderately breast ptosis and a small cup size.
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Affiliation(s)
- Chiara Stocco
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Vito Cazzato
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
| | - Nadia Renzi
- Department of Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy
| | - Mariastella Manara
- Department of Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy
| | - Vittorio Ramella
- Department of Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy
| | - Serena Scomersi
- Department of General Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy
| | - Margherita Fezzi
- Department of General Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy
| | - Marina Bortul
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy; Department of General Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy
| | - Zoran Marj Arnez
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy; Department of Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy
| | - Giovanni Papa
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy; Department of Plastic and Reconstructive Surgery, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste University Hospital, Trieste, Italy
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AboShaban MS, Taalab AA, Ghareeb FM. Verifying the reliability of septum-enhanced inferior pedicle technique for patients with high-grade breast ptosis undergoing reduction mammaplasty. EUROPEAN JOURNAL OF PLASTIC SURGERY 2023. [DOI: 10.1007/s00238-023-02060-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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Wang AT, Panayi AC, Fischer S, Diehm YF, Tapking C, Hundeshagen G, Kneser U, Mastroianni M, Pomahac B, Haug V. Patient-Reported Outcomes After Reduction Mammoplasty Using BREAST-Q: A Systematic Review and Meta-Analysis. Aesthet Surg J 2023; 43:NP231-NP241. [PMID: 36411260 DOI: 10.1093/asj/sjac293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The BREAST-Q questionnaire reduction module is an established tool for outcomes after reduction mammoplasty. OBJECTIVES This systematic review and meta-analysis assess key parameters affecting pre- and postoperative scores, with specific foci on patient characteristics and tissue resection weights. METHODS This study was conducted per PRISMA guidelines. PUBMED (National Institutes of Health; Bethesda, MD), Google Scholar (Google; Mountain View, CA), and Web of Science (Clarivate Analytics; Philadelphia, PA) were searched. All studies published before August 1, 2021, were assessed for eligibility by 2 independent reviewers. Inclusion criteria were prospective or retrospective studies in 6 languages that reported quality of life after reduction mammoplasty employing the BREAST-Q questionnaire reduction module. Quality of included studies was assessed employing the Newcastle-Ottawa-Scale. Analysis was performed per Cochrane Collaboration and the Quality of Reporting of Meta-analyses guidelines. RESULTS A total of 28 papers were included in the systematic review, 13 for preoperative meta-analysis, and 17 for postoperative meta-analysis. Postoperative scores in all 3 quality of life domains (psychosocial, physical, and sexual well-being) and satisfaction with breasts increased significantly after reduction mammoplasty compared with preoperative scores. Satisfaction with breasts showed the greatest improvement, from 22.9 to 73.0. Preoperative scores were lower than normative data, with improvement to comparable scores as the healthy population postoperatively. Improvements in BREAST-Q scores did not correlate with patient comorbidities, complication rates, or amount of breast tissue resected. CONCLUSIONS Reduction mammoplasty provides marked improvement in BREAST-Q patient-reported quality of life as well established in literature. However, these improvements do not correlate with tissue resection weights, warranting further inquiry of insurance-defined resection requirements. LEVEL OF EVIDENCE: 3
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Xiong S, E B, Zhang Z, Tang J, Rong X, Gong H, Yi C. Innovative Application of Three-Dimensional-Printed Breast Model-Aided Reduction Mammaplasty. Front Surg 2022; 9:890177. [PMID: 35756468 PMCID: PMC9223078 DOI: 10.3389/fsurg.2022.890177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
Symptomatic macromastia places a severe physical and psychological burden on patients. Reduction mammaplasty is the primary treatment; however, conventional surgery may lead to postoperative nipple-areolar complex necrosis due to damage to the dominant supplying arteries. In this study, we designed and fabricated an innovative, three-dimensional-printed breast vascular model to provide surgical guidance for reduction mammaplasty. Preoperative computed tomography angiography scanning data of patients were collected. The data were then processed and reconstructed using the E3D digital medical modeling software (version 17.06); the reconstructions were then printed into a personalized model using stereolithography. The three-dimensional-printed breast vascular model was thus developed for individualized preoperative surgical design. This individualized model could be used to intuitively visualize the dominant supplying arteries’ spatial location in the breasts, thereby allowing effective surgical planning for reduction mammaplasty. The three-dimensional-printed breast vascular model can therefore provide an individualized preoperative design and patient education, avoid necrosis of the nipple-areolar complex, shorten operation duration, and ensure safe and effective surgery in patients.
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Affiliation(s)
- Shaoheng Xiong
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Bei E
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Zhaoxiang Zhang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Jiezhang Tang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Xiangke Rong
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Haibo Gong
- The State Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Chenggang Yi
- Department of Plastic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Correspondence: Chenggang Yi
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Payton JI, Abraham JT, Novak MD, Hammonds KP, Altman A. Impact of Patient and Operative Factors on Nipple-Areola Complex Sensation after Bilateral Reduction Mammaplasty. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4353. [PMID: 35673550 PMCID: PMC9162448 DOI: 10.1097/gox.0000000000004353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/01/2022] [Indexed: 06/15/2023]
Abstract
Background Alteration of nipple-areola complex (NAC) sensation following reduction mammoplasty is commonly reported and may impact patient satisfaction. The goal of this study was to evaluate the patient and procedural factors that influence the rates of subjective NAC sensation change. Methods A retrospective review of all patients who underwent primary bilateral reduction mammoplasty between January 2014 and August 2018 at the senior author's institution was performed. The primary outcome measured was subjective NAC sensation via digital stimulation of the NAC with the patient reporting sensation as decreased, unchanged, or increased. Results In total, 274 patients met inclusion criteria. NAC sensation was decreased in 19% of breasts, unchanged in 74%, and increased in 7.3%. Patients who underwent vertical pattern, superomedial pedicle reductions were more likely to report a decrease in sensation than those who underwent Wise pattern, inferior pedicle reductions (26% versus 13%; P = 0.0025). Patients with minor complications were more likely to report decreased NAC sensation than those who did not (23% versus 15%; P = 0.0264). The only factor found to be associated with increased sensation was operative time. Conclusions Patients were more likely to report decreased sensation if a vertical skin resection, superomedial pedicle was chosen, or if patients experienced a minor complication. The only factor found to correlate with increased NAC sensation was longer operative times.
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Affiliation(s)
- Jesse I. Payton
- From the Department of Surgery and Division of Plastic Surgery, Baylor Scott & White – Texas A&M University, Temple, Tex
| | - Jasson T. Abraham
- From the Department of Surgery and Division of Plastic Surgery, Baylor Scott & White – Texas A&M University, Temple, Tex
| | - Matthew D. Novak
- From the Department of Surgery and Division of Plastic Surgery, Baylor Scott & White – Texas A&M University, Temple, Tex
| | - Kendall P. Hammonds
- From the Department of Surgery and Division of Plastic Surgery, Baylor Scott & White – Texas A&M University, Temple, Tex
| | - Andrew Altman
- From the Department of Surgery and Division of Plastic Surgery, Baylor Scott & White – Texas A&M University, Temple, Tex
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Tenna S, Morelli Coppola M, Salzillo R, Barone M, Brunetti B, Cagli B, Cogliandro A, Persichetti P. Delayed Mastopexy Following Breast-Conserving Surgery and Radiation Therapy: A Case-Control Study to Evaluate Safety and Versatility of the Central Mound Technique. Aesthetic Plast Surg 2021; 46:2164-2173. [PMID: 34599353 DOI: 10.1007/s00266-021-02615-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Breast remodeling following breast-conserving surgery (BCS) and radiation therapy (RT) is challenging and often burdened by complications due to irradiated tissue atrophy. The authors present a case-control study to compare the central mound mastopexy (CMM) to more conventional techniques, applying it to different patterns of skin excision. METHODS A variation of the original central mound technique is presented separately addressing glandular and cutaneous deformities. Between 2012 and 2018, 17 consecutive patients presenting defects following unilateral BCS and RT underwent breast remodeling with CMM technique. Immediate and long-term complications together with patient-reported outcomes were evaluated and compared to a matched control group of sixteen patients who underwent superior pedicle mammoplasty. Two independent plastic surgeons reviewed pre- and postoperative photographs and rated the cosmetic outcomes on a visual analog scale from 1 to 5. RESULTS In the study group, different patterns of skin excision, i.e., inverted-T pattern (41.2%), circumareolar (23.5%), skin-sparing type V (17.65%), omega (11.77%), and J (5.88%), were used to correct various breast deformities, and a decisional algorithm was developed. No major complications were registered. Retraction recurrence rate was higher in the control group (p = 0.037). Cosmetic results were considered more satisfying in the CMM group by both patients (4.18 vs 3.00, p<0.001) and surgeons (4.06 vs 2.69, p=0.001). CONCLUSIONS The CMM technique is an advanced approach that addresses breast remodeling after BCS-RT surgery yielding reliable results. Following our algorithm, several patterns of skin excision, tailored to pre-existing scars, can be considered and safely performed. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Stefania Tenna
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Marco Morelli Coppola
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128, Rome, Italy.
| | - Rosa Salzillo
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Mauro Barone
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Beniamino Brunetti
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Barbara Cagli
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Annalisa Cogliandro
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Paolo Persichetti
- Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128, Rome, Italy
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The Central Mound Pedicle: A Safe and Effective Technique for Reduction Mammaplasty. Plast Reconstr Surg 2021; 148:491e-492e. [PMID: 34313643 DOI: 10.1097/prs.0000000000008239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Swanson E. A Review and Measurement Study of the Central Mound Pedicle for Breast Reduction. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3615. [PMID: 34104618 PMCID: PMC8183692 DOI: 10.1097/gox.0000000000003615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/08/2021] [Indexed: 11/26/2022]
Abstract
The central mound approach to breast reduction has been the subject of recent interest in the literature. However, quantitative evaluation using measurements is lacking. This review was undertaken to objectively evaluate changes in breast dimensions, and to compare the results to a popular alternative method, vertical mammaplasty. METHODS An electronic search was performed using PubMed to identify all publications endorsing the central mound technique. Published lateral photographs were matched for size and orientation, with computer assistance. Measurements included breast projection, upper pole projection, lower pole level, breast mound elevation, nipple level, and breast parenchymal ratio. Results were compared with published measurement data for the vertical technique. RESULTS Twenty-three manuscripts were identified. Ten included photographs suitable for analysis. On average, breast projection decreased 1.1 cm after central mound breast reduction (P < 0.05). Upper pole projection dropped 0.4 cm (not significant). The lower pole level was raised 2.6 cm (P < 0.05). The nipple level was over-elevated 0.6 cm, on average. The breast parenchymal ratio increased by 0.54. A central mound dissection decreased breast projection. In contrast, publications using a vertical breast reduction demonstrated maintenance of upper pole and breast projection and a modest (<1 cm) increase. CONCLUSIONS For each measurement comparison, the vertical method outperforms the central mound. Because of its anatomy and geometry, measurements show that the vertical method for breast reduction is more favorable than a central mound dissection. This method can also be used safely for secondary breast reductions.
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