Vertical scar reduction mammaplasty: a 15-year experience including a review of 250 consecutive cases.

BACKGROUND Vertical scar reduction mammaplasty has the advantage of reduced scar burden and improved long-term projection of the breasts. The technique has been criticized for being restricted to cases of mild to moderate mammary hypertrophy and is considered more intuitive and difficult to learn when compared with more conventional inverted-T scar reduction mammaplasties. This article describes the technique used in the largest reported series of vertical scar reduction mammaplasties performed by a single surgeon. METHODS The technique performed in this series uses a mosque dome skin marking pattern; transposition of the nipple-areola complex on a superior or medial dermoglandular pedicle, depending on its position with respect to the skin markings; an excision en bloc of skin, fat, and gland; postexcision liposuction; and wound closure in two planes, with gathering of the skin of the vertical wound. A chart review of 250 consecutive patients treated between November of 2000 and December of 2003 was performed. RESULTS The average reduction per breast (including liposuction) was 636 g (range, 60 to 2020 g). Complications were minimal (5.6 percent of breasts), with no nipples being lost, attesting to the safety of this technique. CONCLUSIONS This technique for vertical scar reduction mammaplasty has been applied to breast reductions of all sizes and has consistently produced good breast shape, with an operation that is shorter to perform and leaves less scarring than standard breast reductions. This technique is straightforward and easy to learn, and offers a safe, effective, and predictable way for treating mammary hypertrophy.