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A Three-Dimensional Comparison Of Breast Reduction Techniques
Rachel Lentz, B.A., Misia Yuhasz, B.S., Stephanie Kwei, M.D.
Yale University, New Haven, CT, USA.

Purpose: Reduction mammoplasty is one of the most frequently performed breast operations in the United States. Inferior based pedicles remain the most commonly used technique by plastic surgeons today. Proponents of superomedial based pedicles claim superior aesthetics and maintenance of breast shape and projection over time. The purpose of this study is to compare the early post-operative morphologic and volumetric changes occurring with superomedial and inferior pedicle breast reduction techniques.
Methods: Patients were randomized to undergo either superomedial or inferior pedicle reduction mammoplasty. Pre-operative and post-operative 3D photographs were obtained using the Canfield Vectra surface photoimaging system. Postoperative images were taken at 1 and 3 months. Total breast volume, volumetric tissue distribution in the superior, inferior, medial and lateral poles, and surface and vector measurements were assessed.
Results: Seven patients (14 breasts) underwent superomedial pedicle reductions and 4 patients (8 breasts) underwent inferior pedicle reductions with volumetric analysis at 1 month and 3 months post-op. Total breast volume decreased significantly from pre- to postoperative scans (P<0.01) with increased volume distribution in the superior poles (P<0.01) for both groups. During the early post-operative period, the superomedial pedicle reduction group experienced a 3% decrease in superior pole tissue distribution (p = 0.064) whereas the inferior pedicle reduction group experienced a 14% decrease in superior pole tissue distribution (p<0.01).
Conclusions: Both superomedial and inferior pedicle breast reductions produce breast shapes with increased superior pole tissue distribution following surgery. Inferior pedicle breast reductions have a greater redistribution of tissue from the superior pole to the inferior pole during the early post-operative period.


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