Aesthetic Plastic Surgery

, Volume 43, Issue 1, pp 27–35 | Cite as

Breast Reduction Using the Superomedial Pedicle- and Septal Perforator-Based Technique: Our Clinical Experience

  • A. UsluEmail author
  • M. A. Korkmaz
  • A. Surucu
  • A. Karaveli
  • C. Sahin
  • M. G. Ataman
Original Article Breast Surgery



Adequate tissue removal must be performed for symptom relief following reduction mammoplasty. However, this is not always possible in patients with gigantomastia because the pedicle is planned wider and the breast cannot be sufficiently reduced to prevent compromising the blood supply to the pedicle. To maximize blood circulation to the nipple–areola complex in our patients, the pedicle was planned to include the internal thoracic artery branches coming from both the second and third interspaces and the intercostal artery branches coming from the fourth and fifth intercostal spaces.


A total of 185 patients underwent reduction mammoplasty with the superomedial pedicle- and septal perforator-based technique. The mean weight of excised tissue was 928.77 g from the right breast and 899.92 g from the left, whereas the mean distance of nipple–areola transfer was 11.52 cm on the right breast and 11.27 cm on the left.


Complications developed in 11 patients (5.94%): hematoma occurred in three patients, partial loss of areola and fat necrosis in five patients, and wound dehiscence in three patients.


The pedicle included vessels of both superomedial and septum origin without any disruption in circulation. Consequently, the blood supply of the nipple–areola complex was preserved. Furthermore, in cases where the pedicle was long, intercostal perforators were identified and the pedicle was narrowed thoroughly; thus, the breast was reduced to the desired volume while minimizing the risk of complications.

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


Reduction mammoplasty Breast reduction Superomedial pedicle technique Septal perforator technique Gigantomastia 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interests.

Ethical Standards

All procedures performed in studies involving human participants were undertaken in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

For this type of study formal consent is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive SurgeryAntalya Training and Research HospitalAntalyaTurkey
  2. 2.Department of Anesthesiology and ReanimationAntalya Training and Research HospitalAntalyaTurkey
  3. 3.Departman of Plastic and Reconstructive SurgeryHaydarpasa Sultan Abdulhamid Training and Research HospitalIstanbulTurkey
  4. 4.Departman of Plastic and Reconstructive SurgeryCankırı State HospitalCankırıTurkey

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