Purpose

Reduction mammoplasty provides enormous satisfaction to patients who suffer from mastodynia and macromastia. Traditional approaches can induce a “bottoming out” effect as well as leave conspicuous T incision scars. We propose a new technique to achieve reliable and reproducible breast reductions, vis à vis volume and size, while eliminating the vertical scar.

Methods: The new nipple location is determined relative to the infra-mammary fold. To be a candidate for this procedure, the distance between the desired NAC and and the actual NAC must be > 7cm. An ellipse of tissue around the NAC down to the infra-mammary fold is de-epithelialized, creating dermal flaps. Parenchyma is resected from the superior, lateral, and medial poles. The central mound with NAC is molded and contoured by suspending the dermal flaps to one another as well as to the chest wall. The skin is then redraped and the nipple is re-inset superiorly in its new location.

Results/Conclusion

17 patients have undergone the above technique with a 2-year follow-up. In our series, we have maintained breast height, shape, and projection without “bottoming out.” Our scheme of internal structural support and suspension will obviate the limitations and the vertical scar encountered by traditional reduction approaches.