Introduction: Bottoming out is a frequent pitfall of breast
reduction following inferior pedicle technique. This is attributed
to the lack of deep tissue suspension and skin envelope
relaxation. The condition is associated with lack of medial
fullness and poor projection. The authors present a new
technique that depends on redistribution and auto-augmentation
rather than resection of tissues.
Patients and Methods: The technique was performed in
25 patients who had bottoming out following inferior pedicle
breast reduction. The time elapsed from the primary surgery
to the corrective surgery ranged from 2 to 4.5 years with a
mean of 2.5 years. The used technique consists of deepithelialization
and complete division of the lower segment at the
infra-mammary fold. The divided lower dermoglandular
segment is rolled in a retromammary pocket underneath the
pedicle and fixed to the pectoral fascia. The idea is to use this
lower segment of the inferior pedicle as an auto-prosthesis.
Follow-up period is 12 months.
Results: All patients achieved good breast shape with
good projection. There were no serious complications. Only
two patients developed partial wound disruption.
Conclusion: A novel technique for correction of bottoming
out following inferior pedicle breast reduction was used with
good surgical outcome