Background: The inferior pedicle wise pattern breast
reduction is one of the most popular techniques used. However,
a major criticism of inferior pedicle technique is bottoming
out of the breast and lack of upper pole fullness. This is caused
by gravitational pressure of the breast parenchyma/pedicle
on the inferior pole with subsequent scaphoid appearance in
the upper pole and lengthening of the vertical scar. In this
study, a modification of the inferior pedicle technique will be
done by creation of two lateral dermal flaps alongside with
the inferior pedicle, and using these flaps to suspend the
pedicle to the chest wall and prevent its descent to evaluate
its effect on prevention of bottoming out of the breast.
Patients and Methods: This is a prospective randomized
study that included 20 healthy female patients suffering from
breast hypertrophy and they are candidate for reduction
mammoplasty by the proposed technique. Design of skin
marking for inferior pedicle breast reduction technique was
carried out with the standard wise pattern with the creation
of two wings (medial and lateral) at the middle of the inferior
pedicle; composed of de-epithelialized dermal flaps. Buttressing
these two wings to the pectoral fascia at the suitable
distances would create a sort of an internal bra effect; which
supports the inferior pedicle. During the follow up, the length
of the vertical scar (as an indicator of bottoming out) was
measured immediately postoperative and every 3 months in
the follow-up period.
Results: This study includes 20 female patients of an age
ranged between 22-51 years old and a breast size (suprasternal
notch to nipple distance) ranging from 31 to 44cm. The followup
for 1-year post-operative shows change in the areola to
fold distance by a ratio satisfaction reaching 60%.
Conclusion: From this study we concluded that the inferior
pedicle suspension to pectoral fascia improve the result shape
of the breast and decrease the bottoming out of the breast.