The "dermal cage": a modification of the inferior pedicle breast reduction

Scientific paper - Original scientific paper

• Author: Rado Žic
• Author: Zlatko Vlajčić
• Author: Daemon Dewing
• Author: Mario Zambelli
• Author: Zdenko Stanec
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

In spite of more recent techniques for breast reduction, the inferior pedicle technique has proven to be enduring and still a very popular option in the plastic surgeon's armamentarium despite certain shortcomings. This technique is especially important for treating large breasts with a long sternal notch-to-nipple distance. The modifications we describe in this article overcome some of the main drawbacks of the standard inferior pedicle technique and make the procedure particularly effective when used on appropriately selected patients. This is achieved principally by the creation of a strong, durable, and internalized "dermal cage" that remains fixed to the chest wall in the upper part, as well as on both sides, to support the majority of the remaining breast tissue. This serves several purposes, including narrowing the breast thereby giving good projection and reduction of the N-IMF length of the inferior pedicle. Through suspension and fixation of the inferior pedicle to the chest wall, one can mitigate the effects of gravity on the inferior pedicle. The benefits of this include reduced tension on the T junction, thereby reducing the incidence of wound dehiscence in the immediate postoperative period, while reduction of tension on the nipple-areola complex reduces "bottoming" out over the long term. This process has been the main shortcoming of the inferior pedicle technique to date. The technique was used on 26 patients over a 7-year period with a mean long-term follow-up of 41 months. The results demonstrate the short- and long-term effectiveness of our own particular combination of modifications to previously described techniques and modifications of the inferior pedicle breast reduction. ----- LEVEL OF EVIDENCE V:

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• Keywords (english): Adult; Aged; Breast/abnormalities; Breast/pathology; Breast/surgery; Cicatrix/prevention & control; Cohort Studies; Esthetics; Female; Follow-Up Studies; Humans; Hypertrophy/diagnosis; Hypertrophy/surgery; Mammaplasty/methods; Middle Aged; Postoperative Care/methods; Retrospective Studies; Risk Assessment; Skin Transplantation/methods; Surgical Flaps/blood supply; Suture Techniques; Wound Healing/physiology; Young Adult
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: Aesthetic Plastic Surgery
• Numbering: vol. 37, no. 2, pp. 364-371
• p-ISSN: 0364-216X
• DOI: https://doi.org/10.1007/s00266-012-0030-z
• URN:NBN: urn:nbn:hr:105:846209
• Publication: 2013-04
• Document URL: https://doi.org/10.1007/s00266-012-0030-z
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-27 19:51:02