PURPOSE The vertical reduction mammaplasty is a procedure that is steadily increasing in popularity in the United States.  Although numerous techniques exist for performing this operation, many of the adverse outcomes are similar in nature.  This article evaluates the unfavorable outcomes that we encountered in 260 consecutive vertical reduction mammaplasty patients, and examines the range of complications seen in other studies.     

METHOD

We reviewed the charts of 260 consecutive patients that underwent vertical reduction mammaplasty by the senior author at one of four institutions.  All surgeries were performed using a superior pedicle vertical incision technique with varying amounts of suction assisted lipectomy. 

RESULTS Unfavorable outcomes that have been encountered at our institution include; scarring (10%); necrosis (1.92%) and wound dehiscence (10%); areola (6.54%) and breast distortion or asymmetry (15%); and hematoma or seroma formation (1.54%).  These results vary greatly in severity and necessity of intervention.

CONCLUSION

Since the advent of the vertical reduction, numerous modifications have been proposed to improve final outcomes and limit complications.  Based on our observations and those of other studies we believe that complication rates are greatly influenced by the amount of liposuction and undermining, the extent of post-operative care, and the steep learning curve of the operation.

While there is a wide spectrum of complication rates among the different techniques of vertical reduction, the outcomes are often similar.  We have observed these complications in a wide patient demographic and believe that the examples provided in this article can be extrapolated to other vertical incision techniques.  An assessment of these complications is necessary to provide patients with proper pre-operative counseling about the risks and consequences of these potential sequela.