Abstract: A Matched Cohort Study of Superomedial Pedicle Vertical Scar Breast Reduction (100 breasts) and Traditional Wise-Pattern Breast Reduction (100 breasts): An Outcomes Study Over Three Years (Plastic Surgery 2012)

Sunday, October 28, 2012: 8:45 AM

Anuja K. Antony, MD, MPH, FACS , Plastic and Reconstructive Surgery, University of Illinois at Chicago, Chicago, IL

Sara Yegiyants, MD, MS , Plastic and Reconstructive Surgery, University of Illinois at Chicago, Chicago, IL

Steven Wisel, BS , University of Illinois, Chicago, Chicago, IL

David Hayes, MD , Plastic and Reconstructive Surgery, University of Illinois at Chicago, Chicago, IL

David Morris, MD , Plastic and Reconstructive Surgery, University of Illinois at Chicago, Chicago, IL

Rudolph F. Dolezal, MD, FACS , Plastic Surgery, University of Illinois, Chicago, Arlington Heights, IL

Mimis N. Cohen, MD , Division Plastic Surgery M/C 958, Chicago, IL

Presentation PDF file

Background: The superomedial pedicle (SMP) with vertical scar breast reduction (BR) is gaining popularity for its round, projecting breast and shorter incision when compared to the traditional Wise-pattern reduction using an inferior pedicle(IFP). However, there is paucity of large volume institutional outcomes studies after SMP/BR. The purpose of this study is to compare outcomes after SMP/BR and IFP/BR in the largest matched cohort study-to-date.

Methods: A retrospective review of a prospectively-maintained database of all bilateral BRs over the three-year period was performed. 100 SMP/BR breasts(50 patients) were matched to 100 IFP/BR breasts(50 patients). Matching was implemented based on age(+/-3 years) and size of reduction(+/-200 grams). Patient demographics, comorbidities, BMI, size of reduction, NAC sensitivity, minor and major postoperative complications, and aesthetic result were assessed.

Results: 286 patients underwent bilateral BR between 1/2009-2/2012 at a single institution; IFP/BR was used in 78% of cases. Mean age and BMI was 32(15-53 yrs) and 32(26-41) in SMP/BR and 32(15-56 yrs) and 32(25-37) in the IFP/BR. Mean volume of tissue reduced was 789 g(range 200-2068g) and 859 g(250-2228g), respectively. All patients achieved symptomatic relief. 2/100 in SMP cohort had decreased nipple sensation immediately post-op with ultimate recovery; compared with 6/100 in the IFP cohort with recovery in 5 of 6. No statistical difference in major or minor complications was seen between two cohorts; SMP: major 5% (seroma 3%;dehiscence 1%;cellulitis 1%) and minor wound complications 7% versus IFP: major 5%(NAC necrosis 1%;hematoma 2%;wound infection 1%) and minor wound complications 5%. Aesthetic result was good-excellent in SMP/BR and fair-excellent in IFP/BR.

Conclusions: SMP/BR is a novel, alternative reduction mammaplasty technique with low complication rates and excellent functional and aesthetic outcomes.

21302 A Matched Cohort Study of Superomedial Pedicle Vertical Scar Breast Reduction (100 breasts) and Traditional Wise-Pattern Breast Reduction (100 breasts): An Outcomes Study Over Three Years