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Breast Reduction: The Superolateral Dermoglandular Pedicle Revisited

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  • Breast Surgery
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Abstract

Background

Breast hypertrophy, generally found in association with ptosis, is a common problem in postadolescent women. Beyond the psychological burden of excessively heavy, droopy breasts, physical symptoms compound the condition, with neck, shoulder and back pain. Reduction mammaplasty is one of the most common cosmetic operations, especially to improve patient’s musculoskeletal symptoms, with proven benefits in patient satisfaction and self-esteem postoperatively. Multiple techniques exist for breast reduction, with no clear evidence of benefit of one over another.

Methods

We review the senior author’s experience in using a superolateral pedicle for breast reduction in 726 patients over the past 40 years. Over the past 10 years, the technique has also been adapted for simultaneous augmentation–mastopexy, especially in post-bariatric surgery patients. Benefits include recruitment of lateral breast tissue to fill the upper pole and correct axillary fullness. The technique has the advantages of ease of execution and a low complication rate.

Results

Complete data were available for 397 patients. Resection weights varied from 380 to 1248 g, and mean sternal notch–nipple distance was 25.3 cm. Mean follow-up was 22 months. Complications were uncommon: four cases of partial nipple-areola complex loss, dehiscence in 14 patients, three hematomas and seven cases of superficial surgical site infection. Nipple sensitivity was decreased in eight patients, and three patients were unable to breastfeed following surgery. Revision surgery was requested by 14 patients.

Conclusions

Breast reduction using the superolateral dermoglandular flap is easy to execute, versatile, safe and effective, preserving physiological functions, and is an excellent option when treating patients with medium-to-large breasts.

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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Authors and Affiliations

  1. Plastic Surgery Division, Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil

    Carlos Oscar Uebel, Pedro Salomão Piccinini & Renato Franz Matta Ramos

  2. General Surgery Service, Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil

    Karina Meneguzzi

  3. Vitor Hugo Str, 78, Porto Alegre, RS, 90630-070, Brazil

    Carlos Oscar Uebel

Authors
  1. Carlos Oscar Uebel
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  2. Pedro Salomão Piccinini
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  4. Karina Meneguzzi
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Correspondence to Carlos Oscar Uebel.

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

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Uebel, C.O., Piccinini, P.S., Ramos, R.F.M. et al. Breast Reduction: The Superolateral Dermoglandular Pedicle Revisited. Aesth Plast Surg 43, 36–45 (2019). https://doi.org/10.1007/s00266-018-1225-8

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  • DOI: https://doi.org/10.1007/s00266-018-1225-8

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