Monday, November 4, 2002 - 4:42 PM

Why Did We Change Our Technique from a Superior Pedicle into a Laterocentral Glandular Pedicle for Breast Reduction?

Moustapha Hamdi, MD, Phillip Blondeel, MD, PhD, Karlien Van deSijpe, MD, Koenraad Van Landuyt, MD, and Stan Monstrey, MD.

Introduction: A new technique of breast reduction with a laterocentral glandular pedicle has been used in our institute since 1999. Using this technique, a prospective study is conducted in order to assess the nipple-areola sensitivity quantitatively. Material and Methods: The pedicle is based on a horizontal septum and it is designed to incorporate the lateral branch of the fourth intercostal vessels and of the nerve. The operative technique will be illustrated. The sensitivity of the nipple-areola complex was evaluated in 20 consecutive patients by one independent examiner preoperatively, 2 weeks and three months postoperatively. Nipple and four cardinal points of the areola were tested. Pressure thresholds were measured with Semmes-Weinstein monofilaments, temperature sensitivity with hot 40c and cold 4c metal probes and vibratory thresholds with the Biothesiometer. Average sensation of the areola was calculated by means of the four areas tested. Results: A series of 45 patients underwent breast reduction by the same surgeon between with a mean follow-up of 13 months. Mean sternum-nipple distance was 31 cm (19-40 cm). Mean resection was 624 g (40-1680g). One partial areola necrosis was reported. The pressure and the vibration sensitivity decreased at 2 weeks postoperatively. However, None of these differences was statistically significant. At three months postoperatively, Thethresholds were quite similar to preoperative values of both areola and nipple. Concerning the ability to recognize temperature, 40 % and 80% of patients could distinguish between cold and hot at 2 weeks and 3 months after surgery respectively. Conclusion: The laterocentral glandular pedicle technique shows clear advantages over the conventional techniques of breast reduction in terms of breast sensation and ease of pedicle shaping and modeling.
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