Abstract: Improving Breast Shape in Breast Reduction Technique: Morphometric Analysis of the Yin-Yang and the Inferior Pedicle Techniques (Plastic Surgery 2013)

Monday, October 14, 2013: 10:45 AM

Francesco Gargano, MD, PhD , Plastic Surgery, Brown University, Providence, RI

Lawrence Bowen, MD , Plastic Surgery Department, Brown University, Providence, RI

Jack Bevivino, MD , Plastic Surgery Department, Brown University, Providence, RI

Karen Leong, MD , Plastic Surgery Department, Brown University, Providence, RI

Rachel Sullivan, MD , Plastic Surgery, The Warren Alpert School of Medicine of Brown University, Providence, RI

Lee Edstrom, MD , Plastic Surgery Department, Brown University, Providence, RI

Paul Y Liu, MD , Plastic Surgery Department, Brown University, Providence, RI

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Goals/Purposes: Breast reduction techniques should aim to achieve "ideal breast shape" and to our knowledge no studies have well defined, with accurate measurements, its morphometric changes. Our goal is to compare the inverted T inferior pedicle and the "Yin-Yang" techniques and to evaluate which best achieves the "ideal breast shape".

Methods/Techniques: 1175 inverted T techniques and 89 Yin-Yang have been performed in the last 5 years by five Authors. Our study prospectively analyzes 40 patients divided in two groups: 1) 20 patients who underwent the inferior pedicle inverted T technique and 2) 20 patients with the Yin-Yang technique. The Yin-Yang technique uses the principles of gland remodeling characterized by the following: A) superomedial pedicle for the nipple, B) glandular resection pattern with an S-shape on the right breast and mirrored S-shape on the left breast, C) laterally based inferior pole dermoglandular flap. The movement and interdigitation of the two flaps narrows the mammary base, stabilizes the lower pole and enhances nipple projection. D) Scar length and T-junction tension are minimized by resecting skin excess via tailor-tacking method.

Patients were selected for BMI, grade of hypertrophy and mastopexies were not included. Morphometric analysis was performed collecting mammary base width, nipple projection, NAC and IMF positions, nipple-IMF distance. Photographic documentation with overlapping images was taken before and at patient follow up at 10-14 days, 3, 6 months, and 1 year.

Results: Similar complication rates and nipple sensation findings were detected between the two analyzed techniques. Analysis of the morphometric changes showed statistical significance for base width (p value<0.05) and a trend toward significance for projection (p=0.16) 

Conclusions: The Yin-Yang technique best achieves breast base narrowing and nipple projection while decreasing scar length and tension. The statistical significance in mammary base width (p<0.05) shows the Yin-Yang technique top be most effective in achieving the "ideal breast shape".

Yin-Yang Technique pictures:

Fig.1-2. Yin-Yang Technique. SM NAC pedicle, inferior pole flap, gland resection

Fig.3-5. Yin-Yang Technique. Gland remodeling produces narrowing of the breast base

22520 Improving Breast Shape in Breast Reduction Technique: Morphometric Analysis of the Yin-Yang and the Inferior Pedicle Techniques