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Keywords Breast reduction . Superiomedial pedicle technique . Mammoplasty . Würinger’s septum . Breast hypertrophy .
Background: Reduction mammoplasty is a technique used for treating women with breast hypertrophy, in addition to improving the appearance of these breasts. Hence, the corrections under this mammoplasty include functional and aesthetic outcomes, while preserving the vascularity and sensibility of the breasts.
Aim : To evaluate superomedial septal-based reduction mammoplasty in patients with breast hypertrophy on Nipple Areola Complex (NAC) vascularity, sensibility and overall complications.
Patients and Methods: A total of 29 patients with bilateral breast hypertrophy underwent reduction mammoplasty with the superomedial pedicle and septal perforated technique. The mean distance of SN-N was 36.9 cm on the right side and 37.4 cm on the left side. The mean distance transfer of nipple–areola was 18.2 cm for the right side and 18 cm for the left side. The mean excised tissue was 1283 g from the right side and 1240 g from the left side.
Results: Postoperatively, the mean of SN-N was 21.5 cm for both the right and left side. A limited wound dehiscence occurred in four patients (13.8%), impaired nipple sensation occurred in three patients (10.1%), while infection was found in one patient (3.4%).
Conclusions: In our study, using the superomedial pedicle and septal perforator provided a safe and reliable technique for treating patients with breast hypertrophy, including macromastia and gigantomastia. It minimized the risk of vascular compromise of the NAC. this technique was found to show minor complications and provide good aesthetic outcomes.
2. Kevin C. Chung . Operative technique in plastic surgery . 1st .ed. Vol.3 , Wolter Kluwer, Philadelphia, 2019 ; pp.1340 .
3. Christian J. Gabka, Heinz Bohmert,. Plastic and reconstructive surgery of the breast .2nded., Thieme, Stuttgart, 2009; pp.14 .
4. G- Lemperle J. Nieregelt plastic and reconstructive breast surgery . 1st .ed., Springer, 1991, pp. 20 .
5. Tarik Ezzat Abd- Latif, Mohamed Hassan Abd- El-Al, Ahmed Mohamed Ali, Ali Muftah Shaliout. Breast Reduction with a Superiomedial Pedicle (Hall- Findly’s Technique ): Zagezig University Hospital Experience .Zagozig university Medical Journal . 2019 ; 25(4): 520-528 . 5
6. Michael S. Sabel. Essential of breast surgery .1st ed., Mobsy Elsevier, Philadelphia, 2009; pp 11. 6
7. Mustapha Hamdi , Dennis C. Hammoud , Foad Nahai. Vertical scar mammoplasty . 1st ed., Springer2005 ; pp2,5. 7
8. Dennis C. Hammoud. Atlas of aesthetic breast surgery . 1st ed., Sanndevs Elsevier,2009; pp.4 . 8
9. Aurelio Portincasa, Francesco Ciancio, Luigi Cagiano, Alessandro Innocenti, Domenico Parisi.Septum-Enhanced Mammoplasty in Inferocentral Pedicle Breast Reduction for Macromastia and Gigantomastia Patients. Aesth Plast Surg .2017. doi 10.1007/s00266-017-0868-1 . 9
10. Wei-Qiang Tan, Min-Xia Zhang, Chun-Ye Chen, Qing-Qing Fang, Ji-Hua Xu, and Dong Lou .The folded Mammary Gland For Free- nipple-graft Reduction Mammoplasty . Department of Plastic Surgery , Collage of Medicine, Zhejiang University , Yiwn , Zhejiang Province. P.R. China , 2017. 10
11. Fatma Bilgen, Alper Ural & Mehmet Bekerecioğlu. Inferior and Central Mound Pedicle Breast Reduction in Gigantomastia : A Safe Alternative? . 2019 .Journal of Investigative Surgery .doi.org/10.1080/08941939.2019.1648609. 11
12. V. Bucaria, R- Elia, M. Maruccia, P. Annoscia, A. Boccuzzi, G. Guidice. Why choose the septum – superio- medial (SSM ) – based mammoplasty in patient with severe breast ptosis. An anatomical point of view. Aesthetic Plast Surg. 2018 doi.org/10.1007/s00266-018-1189-8.
13. A. Uslu. M.A. Korkmaz. A. Karaveli. C.Sahin. M. G. Ataman .Breast Reduction Using the Superiomedial Pedicle – and Saptal Perforator- Based Technique : Our Clinical Experience. Aesth Plast Surg. 2018.doi.org/10.1007/s00266-018-1177-z.
14. Hashem Mohammed, M.D. and Mohammed Saad, M.D. The septum – based superomedial pedicle technique in reduction mammoplasty. Egypt, J. Plast. Reconstr. Surg., Vol. 44, No. 2,April: 319-324,2020.
15. Moustapha Hamdi et al. Septum – based mammoplasty . A surgical technique based on Würinger’s septum for breast reduction . Plastic and reconstructive surgery .2009; 123(2):443-454.
16. Van Deventer Pv, Graeme FR . The blood supply of the breast revisited. Plast reconstr surg. 2016;137,1388-1397
17. Hall – Findly EJ, Shestak KC. Breast Reduction. Plast Reconstr Surg. 2015 Oct; 136(4): 531e-44e.
18. Glynn E. Jones. Bostwick’s plastic and reconstructive breast surgery . 4th ed., Thieme medical publisher, 2020,pp.760, 761.
19. Benedetto Longo. Floyd Wilhelmus Timmermans . Alessio Farcomeni. Jacopo Maria Frattaroli .Gennaro D'orsi. Matto Atzeni .Michail Sorotos. Rosaria Laporta . Fabio Santanelli di Pompeo. Septum – Based Mammoplasties: Surgical Techniques and Evaluation of Nipple – Areola Sensibility . Aesth Plast Surg 2020 44:689-697 doi.org⁄10.1007⁄s00266-020-01657-7.
20. Ümran Muslu . Dilek Şenen Demirez.Asim Uslu .Mehmet Ali Korkmaz .Meral Biligilisoy Filiz. Comparison of Sensory Canges Following Superiomedial and Inferior Pedicle Breast Reduction .Aesth Plast Surg DOI 10.1007∕S00266-017-0958-0.
21. Mohamed Makboul, Mahmoud S. Abdelhamid, Ghoda S. Al- Attar.long term follow – up and patient satisfaction after reduction mammoplasty : superomedial versus inferior pedicle. Indian J Plast Surg 2016;214-9.