Defining Pseudoptosis (Bottoming Out) 3 Years Following Short-Scar Medial Pedicle Reduction Mammaplasty

Pseudoptosis (bottoming out, BO) is a well observed phenomenon occurring after all types of breast reduction (BR) surgery. Our team used 3-dimensional (3D) imaging to objectively demonstrate that significant BO occurs in short, scar medial pedicle (MP) BR during the first postoperative year (POY), with no further changes occurring in the second POY. The following study uses 3D imaging to objectively evaluate how the breast changes during the third POY after short-scar, MP BR. Preoperative and postoperative 3D scans (VECTRA 3-pod system, Konica Minolta V910) were taken at the early, 1-, 2-, and 3-year postoperative periods (early = 35-140 days, 1 year = 300-450 days; 2 years = 600-850 days; 3 years = 1000-1300 days). BO was investigated using various 3D parameters and distance measurements including: total breast volume; volumetric tissue distribution below an inframammary (IMF) plane; and vector measurements including maximum anterior-posterior (AP) projection Ten patients had consecutive 3D scans taken preoperatively, the early, 1-, 2-, and 3-year postoperative periods. The average total breast volume significantly decreased from the early to 1-year period by 20.6% (p< 0.05) with no significant change over the second and third POY (p>0.05). The redistribution of the breast parenchyma between the early and 1-year period correlated with an increase of breast tissue in the lower pole (24% to 31%, respectively) and a decrease in breast AP projection of 10.6 mm (p<0.05). The change in tissue below the IMF plane and in AP projection was insignificant during the second and third POY. Additionally, the inter-nipple distance decreased from the early to 1-year period by 10.2mm (p<0.01) with no further change during the second or third postoperative years (p>0.05). This study provides quantifiable data demonstrating BO and tissue redistribution are limited to the initial POY in patients having short-scar MP BR. There appears to be minimal kinetic change in the breasts during the second and third POY. Using 3D photography, plastic surgeons are now able to objectively monitor the postoperative changes in breast morphology.