Three Dimensional Analysis of Early Post-Operative Volumetric and Morphologic Changes Following Vertical Reduction Mammoplasty Using A Superomedial Pedicle

Background:

Reduction mammoplasty is one of the most frequently performed breast operations in the United States. The vertical reduction using a superomedial pedicle technique is slowly gaining more popularity, with proponents claiming that it produces a more aesthetically pleasing breast shape and maintains better projection over time. Prior studies have described the use of 3-dimensional (3D) photography for analysis of the long term changes in volume following medial pedicle breast reductions. The purpose of this study was to use similar 3D technology to analyze the early post-operative morphologic and volumetric changes that occur with the superomedial pedicle technique.

Methods:                                     

Patients undergoing vertical reduction mammoplasty had pre-operative and post-operative 3D photographs taken using the Canfield Vectra surface photoimaging system.  Postoperative images were obtained at 1 and 3 months. The following volumetric and morphologic parameters were assessed: total breast volume, volumetric tissue distribution in the superior, inferior, medial and lateral poles, and surface and vector measurements.

Results:                                                                                                          

3 patients (6 breasts) were analyzed at 1 month post-op, 2 patients (4 breasts) were further analyzed at 3 months. Total breast volume decreased significantly from pre- to postoperative scans (1118 cc to 738cc, P<0.01). Following surgery, percent tissue distribution in the superior poles increased from 36.40% to 85.91% (P<0.01) at 1 month post-op.  Additionally, there was an increase in medial pole tissue distribution, however this was not significant. Between 1 and 3 months post-op, there was no significant change in breast volume (P=0.14), percent tissue distribution in superior pole (P=0.822), or percent tissue distribution in medial pole (P=0.99). There was a slight increase in sternal notch to nipple distance, however this difference was not significant (P=0.51).

Conclusions:

Vertical reduction using a superomedial pedicle produces a breast shape with increased superior pole fullness. Some redistribution in breast tissue from the superior pole to the inferior pole occurs in the months following surgery. Continued follow up images of these patients may provide greater insight into the long term volumetric and morphologic changes that occur with a superomedial pedicle breast reduction. Studies comparing the changes in morphology over time with different techniques of breast reduction are currently underway.