Comparison of the Rubin dermal suspension sutures and total parenchymal reshaping technique with a traditional inverted T-scar reduction mammaplasty technique using a superior pedicle

"The Chignon Mastopexy": A Double Glandular Suspended Flaps for an Auto-Augmentation Effect

BACKGROUND

Many mastopexy techniques have been described in the literature focusing on the new nipple areolar complex position and the breast deflation treatment, but only few of them detailed the glandular volume redistribution to avoid the use of implants. We describe a mastopexy procedure that brings the maximum of the volume to the central part of the breast. We compare the procedure to a "chignon" hair style way to vulgarize the technique and simplify its comprehension.

METHODS

Breast volume is reshaped by the use of a vertical mastopexy and two deepithelized glandular flaps sutured for the first one to the pectoralis major fascia and for the second one to the contralateral flap. A lateral release of two fasciocutaneous flaps allows the final vertical suture.

RESULTS

From January 2011 to January 2016, 30 patients, between 85 operated on for ptotic breasts, were treated with this technique. The follow-up period is from 6 months to 5 years. Esthetic improvement in the breast shape and its projection were achieved in 90%. The illusion of augmentation of the final volume was noticed in 70% of the cases. No complications were noticed during this study.

CONCLUSION

We describe an easy and reliable technique for breast lift, based on a mastopexy method that changes the architecture of the breast to bring the maximum of its volume to the central part. The technique is rewarding for moderate volumes when the ptosis is more related to a glandular sagging than to a cutaneous looseness and breast deflation.

LEVEL OF EVIDENCE IV

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Central pedicle reduction mammaplasty with a vertical scar: a technical modification

BACKGROUND

This study introduces a central pedicle reduction mammaplasty with a vertical scar technique.

OBJECTIVES

This study is aimed to create a more conical breast shape and long-lasting better projection by modifying reduction mammaplasty by central pedicle flap.

METHOD

Preoperative markings were made including the meridian line of breast and the new location of the nipple-areola complex (NAC). The new location of the inframammary fold was marked ∼2 ∼ 4 cm above the original inframammary fold. An incision was made around the areola, the area between the resection margins and NAC was excised en bloc. The breast parenchyma was excised circumferentially, so that a cone shaped central mound was formed. An inferior and inferolateral glandular resection was performed to reduce the area of the breast base by elevating the position of the inframammary fold. After completion of dissection, the central pedicle surmounted by the NAC was transposed to its new location.

RESULT

Fifty-six patients were operated with our modified central pedicle technique. The mean amount of resection was 475 g (range = 130-1080 g). The mean length of follow-up was 18 months (range = 12-53 months). The mean postoperative satisfaction score was 4.23 (SD = 0.81). The breast parenchymal ratio significantly increased from 1.2 preoperatively to 3.9 postoperatively.

CONCLUSION

The modified central pedicle reduction mammaplasty with a vertical scar technique is a versatile breast reduction technique for all shapes and tissue conditions, by providing an attractive conical shape of the breast with minimum scar burden and maximum preservation of breast function.