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Superomedial Pedicle Vertical Scar Breast Reduction: Objective and Subjective Assessment of Breast Symmetry and Aesthetics

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  • Breast Surgery
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Abstract

Background

The superomedial vertical scar breast reduction (SVBR) described by Hall-Findlay is gaining popularity among surgeons worldwide. The aim of this study was to evaluate its long-term aesthetic outcome, the extent of quality of life improvement and the factors that influence patient satisfaction and reviewers’ evaluation of aesthetic/surgical outcome.

Methods

In this historical prospective study, we included women who underwent SVBR at least one year prior to enrollment and responded to a quality of life questionnaire. Their breasts were photographed, measured and evaluated by the plastic surgery staff.

Results

A total of 40 patients responded to the questionnaire, and the breasts of 31 of them were measured and photographed. All 31 patients had good breast symmetry according to objective breast measurements. There was a clear correlation between the patients’ and the reviewers’ scores of breast symmetry, scar appearance and breast shape (r = 0.4–0.65, r = 0.432–0.495 and r = 0.335–0.403, respectively). The factor that most influenced reviewers’ and patients’ satisfaction with the overall aesthetic outcome was the breast-to-body proportion.

Conclusions

The proportions between the breast size and the patient’s body habitus are pivotal to patient satisfaction and should be taken into consideration when planning a reduction mammaplasty. The SVBR technique for breast reduction provided good cosmetic outcome and symmetry over a long-term follow-up.

Level of Evidence IV

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References

  1. Gonzalez F, Walton RL, Shafer B et al (1993) Reduction mammaplasty improves symptoms of macromastia. Plast Reconstr Surg 91:1270–1279

    Article  PubMed  CAS  Google Scholar 

  2. Letterman G, Schurter M (1980) The effects of mammary hypertrophy on the skeletal system. Ann Plast Surg 5:425–431

    Article  PubMed  CAS  Google Scholar 

  3. Davis GM, Ringler SL, Short K et al (1995) Reduction mammaplasty: long term efficacy, morbidity, and patient satisfaction. Plast Reconstr Surg 96:1106–1110

    Article  PubMed  CAS  Google Scholar 

  4. Atterhem H, Holmner S, Janson PE (1998) Reduction mammaplasty: symptoms, complications, and late results. Scand J Plast Reconstr Hand Surg 32:281–286

    Article  CAS  Google Scholar 

  5. Eggert E, Schuss R, Edsander-Nord A (2009) Clinical outcome, quality of life, patient’s satisfaction, and aesthetic results, after reduction mammaplasty. Scand J Plast Reconstr Surg Hand Surg 43:201–206

    Article  PubMed  Google Scholar 

  6. Serletti JM, Reading G, Caldwell E et al (1992) Long term patient satisfaction following reduction mammaplasty. Ann Plast Surg 28:363–365

    Article  PubMed  CAS  Google Scholar 

  7. Wise RJ (1956) A preliminary report of a method of planning the mammaplasty. Plast Reconstr Surg 17:367–375

    Article  CAS  Google Scholar 

  8. Strombeck JO (1960) Mammaplasty: report of a new technique based on the two-pedicle procedure. Br J Plast Surg 13:79–90

    Article  PubMed  CAS  Google Scholar 

  9. Dufourmentel C, Mouly R (1961) Plastie mammaire par la methode oblique (in French). Ann Chir Plast 6:45–58

    PubMed  CAS  Google Scholar 

  10. Skoog T (1963) A technique of breast reduction: transposition of the nipple on a cutaneous vascular pedicle. Acta Chir Scand 126:453–465

    PubMed  CAS  Google Scholar 

  11. Pitanguy I (1967) Surgical treatment of breast hypertrophy. Br J Plast Surg 20:78–85

    Article  PubMed  CAS  Google Scholar 

  12. Lassus C (1970) A technique for breast reduction. Int Surg 53:69–72

    PubMed  CAS  Google Scholar 

  13. McKissock PK (1972) Reduction mammaplasty with a vertical dermal flap. Plast Reconstr Surg 49:245–252

    Article  PubMed  CAS  Google Scholar 

  14. Regnault P (1974) Reduction mammaplasty by the “B” technique. Plast Reconstr Surg 53:19–24

    Article  PubMed  CAS  Google Scholar 

  15. Ribeiro L (1975) A new technique for reduction mammaplasty. Plast Reconstr Surg 55:330–334

    Article  PubMed  CAS  Google Scholar 

  16. Robbins TH (1977) A reduction mammoplasty with the areola-nipple based on an inferior dermal pedicle. Plast Reconstr Surg 59:64–67

    Article  PubMed  CAS  Google Scholar 

  17. Marchac D, de Olarte G (1982) Reduction mammaplasty and correction of ptosis with a short inframammary scar. Plast Reconstr Surg 69:45–55

    Article  PubMed  CAS  Google Scholar 

  18. Hester TR Jr, Bostwick J III, Miller L et al (1985) Breast reduction utilizing the maximally vascularized central breast pedicle. Plast Reconstr Surg 76:890–900

    Article  PubMed  Google Scholar 

  19. Lejour M, Abboud M, Declety A et al (1990) Reduction of mammaplasty scars: from a short inframammary scar to a vertical scar (in French). Ann Chir Plast Esthet 35:369–379

    PubMed  CAS  Google Scholar 

  20. Benelli L (1990) A new periareolar mammaplasty: the “round block” technique. Aesthet Plast Surg 14:93–100

    Article  CAS  Google Scholar 

  21. Hammond DC (1999) Short scar periareolar inferior pedicle reduction (SPAIR) mammaplasty. Plast Reconstr Surg 103:890–891

    Article  PubMed  CAS  Google Scholar 

  22. Hall-Findlay EJ (1999) A simplified vertical reduction mammaplasty: shortening the learning curve. Plast Reconstr Surg 104:748–759

    Article  PubMed  CAS  Google Scholar 

  23. Sampaio Goes JC (2002) Periareolar mammaplasty: double skin technique with application of mesh support. Clin Plast Surg 29:349–364

    Article  PubMed  Google Scholar 

  24. Blondeel PN, Hamdi M, Van de Sijpe KA et al (2003) The latero-central glandular pedicle technique for breast reduction. Br J Plast Surg 56:48–359

    Google Scholar 

  25. Antony AK, Yegiyants SS, Danielson KK et al (2013) A matched cohort study of superomedial pedicle vertical scar breast reduction (100 breasts) and traditional inferior pedicle wise-pattern reduction (100 breasts): an outcomes study over 3 years. Plast Reconstr Surg 132:1068–1076

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Serra P, Longhi P, Sinha M (2010) Breast reduction with a superomedial pedicle and a vertical scar (Hall-Findlay’s technique): experience with 210 consecutive patients. Ann Plast Surg 64:275–278

    Article  PubMed  CAS  Google Scholar 

  27. Lista F, Austin RE, Singh Y et al (2015) Vertical scar reduction mammaplasty. Plast Reconstr Surg 136:23–25

    Article  PubMed  CAS  Google Scholar 

  28. Finger RE, Vasquez B, Drew GS et al (1989) Superomedial pedicle technique of reduction mammaplasty. Plast Reconstr Surg 83:471–480

    Article  PubMed  CAS  Google Scholar 

  29. Spear SL, Howard MA (2003) Evolution of the vertical reduction mammaplasty. Plast Reconstr Surg 112:855–868

    Article  PubMed  Google Scholar 

  30. Chen CM, White C, Warren SM et al (2004) Simplifying the vertical reduction mammaplasty. Plast Reconstr Surg 113:162–172

    Article  PubMed  Google Scholar 

  31. Yuksel F, Karagoz H, Sever C et al (2012) Experience with vertical mammaplasty: advantages and drawbacks of Hall-Findlay’s superomedial pedicle technique and improving the results by adding modifications to the technique. Aesthetic Plast Surg 36:1329–1333

    Article  PubMed  Google Scholar 

  32. Birtchnell S, Whitfield P, Lacey JH (1990) Motivational factors in women requesting augmentation and reduction mammaplasty. J Psychosom Res 34:509–514

    Article  PubMed  CAS  Google Scholar 

  33. Catanuto G, Patete P, Spano A et al (2009) New technologies for the assessment of breast surgical outcomes. Aesthet Surg J 29:505–508

    Article  PubMed  Google Scholar 

  34. Strasser EJ (1999) An objective grading system for the evaluation of cosmetic surgical results. Plast Reconstr Surg 104:2282–2285

    Article  PubMed  CAS  Google Scholar 

  35. Goldwin Y, Wood SH, O’Neill TJ (1998) A comparison of the patient and surgeon opinion on the long-term aesthetic outcome of reduction mammaplasty. Br J Plast Surg 51:444–449

    Article  Google Scholar 

  36. Berg A, Plamer B (1997) Quality assurance in plastic surgery: reduction mammaplasty. Scand J Plast Reconstr Surg 31:327–331

    Article  CAS  Google Scholar 

  37. Westreich M (1997) Anthromorphic breast measurement: protocol and results in 50 women with aesthetically perfect breasts and clinical application. Plast Reconstr Surg 100:468–479

    Article  PubMed  CAS  Google Scholar 

  38. Grossman AJ, Roudner LA (1980) A simple means for accurate breast volume determination. Plast Reconstr Surg 66:851–852

    Article  PubMed  CAS  Google Scholar 

  39. Loughry CW, Sheffer DB, Price TE et al (1989) Breast volume measurement of 598 women using biostereometric analysis. Ann Plast Surg 22:380–385

    Article  PubMed  CAS  Google Scholar 

  40. Daly SE, Kent JC, Huynh DQ et al (1992) The determination of short-term breast volume changes and the rate of synthesis of human milk using computerized breast measurement. Exp Physiol 77:79–87

    Article  PubMed  CAS  Google Scholar 

  41. Herold C, Reichelt A, Stieglitz LH et al (2010) MRI-based breast volumetry-evaluation of three different software solutions. J Digit Imaging 23:603–610

    Article  PubMed  PubMed Central  Google Scholar 

  42. Choppin SB, Wheat JS, Gee M et al (2016) The accuracy of breast volume measurement methods: a systematic review. Breast 28:121–129

    Article  PubMed  CAS  Google Scholar 

  43. Malata CM, Boot JC, Bradbury ET et al (1994) Congenital breast asymmetry: subjective and objective assessment. Br J Plast Surg 47:95–102

    Article  PubMed  CAS  Google Scholar 

  44. Smith DJ, Paline WE, Katch V et al (1986) Surgical treatment of congenital breast asymmetry. Ann Plast Surg 17:92–101

    Article  PubMed  Google Scholar 

  45. Stark B, Olivary N (1991) Breast asymmetry: an objective analysis of postoperative results. Eur J Plast Surg 14:173–176

    Article  Google Scholar 

  46. Pusic AL, Klassen AF, Scott AM et al (2009) Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 124:345–353

    Article  PubMed  CAS  Google Scholar 

  47. Coriddi M, Nadeau M, Taghizadeh M et al (2013) Analysis of satisfaction and well-being following breast reduction using a validated survey instrument: the BREAST-Q. Plast Reconstr Surg 132:285–290

    Article  PubMed  CAS  Google Scholar 

  48. Meshulam-Derazon S, Barnea Y, Zaretski A et al (2009) Large-volume breast reduction: long-term results. Scand J Plast Reconstr Surg Hand Surg 43:65–70

    Article  PubMed  Google Scholar 

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Acknowledgements

No outside funding was provided for this paper. Dr. Barnea is a speaker for Johnson Medical. We thank Esther Eshkol for editorial assistance.

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Correspondence to Yoav Barnea.

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Ron, O., Inbal, A., Arad, E. et al. Superomedial Pedicle Vertical Scar Breast Reduction: Objective and Subjective Assessment of Breast Symmetry and Aesthetics. Aesth Plast Surg 42, 639–647 (2018). https://doi.org/10.1007/s00266-017-1015-8

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  • DOI: https://doi.org/10.1007/s00266-017-1015-8

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