CME Evolution of the Vertical Reduction Mammaplasty

نویسندگان

  • Scott L. Spear
  • Michael A. Howard
چکیده

A recent survey found that the inferior pedicle, inverted-T skin pattern is still the most common breast reduction technique used among U.S. plastic surgeons.1 This technique has been widely taught in North America and is familiar to most American plastic surgeons. Using the skin markings of this technique, the glandular excess, skin envelope, and nipple position may be readily and reliably addressed. Surgeons recognize some potential drawbacks to this procedure, particularly the long inframammary transverse scar and a propensity for pseudoptosis or “bottoming out.”2 Over time, various authors have sought to address these issues3–34 through the vertical reduction pattern. However, this method of breast reduction has been the topic of heated debate and remains a source of great confusion to many. Reviewing the evolution of vertical reduction mammaplasty techniques should help to clarify some of the misconceptions that persist surrounding this topic. It is critically important to realize that in breast reduction surgery, the pedicle and the skin excision pattern can be independent variables. Wise’s original description in 1956 was of a skin excision pattern only. The Wise “inverted-T” and “vertical” patterns may both be combined with several different nipple pedicles, including an inferior, central, superior, medial, lateral, or McKissock bipedicle. Most of the well-known named procedures have both a specific pedicle and a distinct incision pattern. Reviewing the evolution of vertical reduction techniques should help clarify the current state of the art of this method of breast reduction, including the pros and cons of each specific procedure.

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تاریخ انتشار 2003