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CC BY-NC-ND 4.0 · Indian J Plast Surg 2013; 46(02): 401-407
DOI: 10.4103/0970-0358.118620
Review Article
Association of Plastic Surgeons of India

Unfavourable results following reduction mammoplasty

Lakshmi Saleem
Salaja Hospitals, Vijayawada, Andhra Pradesh, India
,
Jerry R. John
Department of Plastic Surgery, PGIMER, Chandigarh, India
› Author Affiliations
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Publication History

Publication Date:
07 October 2019 (online)

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ABSTRACT

Breast reduction is a common cosmetic surgical procedure. It aims not only at bringing down the size of the breast proportionate to the build of the individual, but also to overcome the discomfort caused by massive, ill-shaped and hanging breasts. The operative procedure has evolved from mere reduction of breast mass to enhanced aesthetic appeal with a minimum of scar load. The selection of technique needs to be individualised. Bilateral breast reduction is done most often. Haematoma, seroma, fat necrosis, skin loss, nipple loss and unsightly, painful scars can be the complications of any procedure on the breast. These may result from errors in judgement, wrong surgical plan and imprecise execution of the plan. Though a surfeit of studies are available on breast reduction, very few dwell upon its complications. The following article is a distillation of three decades of experience of the senior author (L.S.) in reduction mammoplasty. An effort is made to understand the reasons for unfavourable results. To conclude, most complications can be overcome with proper selection of procedure for the given patient and with gentle tissue handling.

KEY WORDS

Breast - complications - fat necrosis - reduction mammoplasty - seroma
 
  • 1 Wise RJ. A preliminary report on a method of planning the mammaplasty. Plast Reconstr Surg (1946) 1956;17:367-75.
  • 2 Wise RJ, Gannon JP, Hill JR. Further experience with reduction mammaplasty. Plast Reconstr Surg 1963;32:12-20.
  • 3 Lassus C. A 30-year experience with vertical mammaplasty. Plast Reconstr Surg 1996;97:373-80.
  • 4 Lejour M. Vertical mammaplasty and liposuction of the breast. Plast Reconstr Surg 1994;94:100-14.
  • 5 Hall-Findlay EJ. A simplified vertical reduction mammaplasty: Shortening the learning curve. Plast Reconstr Surg 1999;104:748-59;760.
  • 6 Benelli L. A new periareolar mammaplasty: The "round block" technique. Aesthetic Plast Surg 1990;14:93-100.
  • 7 Thorek M. Possibilities in the reconstruction of the human form. Med J Rec 1922;116:572.
  • 8 McGregor JC, Hafeez A. Is there still a place for free nipple areolar grafting in breast reduction surgery? A review of cases over a three year period. J Plast Reconstr Aesthet Surg 2006;59:213-8.
  • 9 Orton C. Commentary: Is there still a place for free nipple areolar grafting in breast reduction surgery? A review of cases over a three year period. J Plast Reconstr Aesthet Surg 2006;59:219-20.
  • 10 Scott GR, Carson CL, Borah GL. Maximizing outcomes in breast reduction surgery: A review of 518 consecutive patients. Plast Reconstr Surg 2005;116:1633-9.
  • 11 Hammond DC, Loffredo M. Breast reduction. Plast Reconstr Surg 2012;129:829e-39.
  • 12 Shermak MA, Chang D, Buretta K, Mithani S, Mallalieu J, Manahan M. Increasing age impairs outcomes in breast reduction surgery. Plast Reconstr Surg 2011;128:1182-7.
  • 13 Nahai FR, Nahai F. MOC-PSSM CME article: Breast reduction. Plast Reconstr Surg 2008;121:1-13.
  • 14 Eggert E, Schuss R, Edsander-Nord A. Clinical outcome, quality of life, patients′ satisfaction, and aesthetic results, after reduction mammaplasty. Scand J Plast Reconstr Surg Hand Surg 2009;43:201-6.
  • 15 Stevens WG, Cohen R, Vath SD, Stoker DA, Hirsch EM. Is it safe to combine abdominoplasty with elective breast surgery? A review of 151 consecutive cases. Plast Reconstr Surg 2006;118:207-12.
  • 16 Regnault P. Breast ptosis. Definition and treatment. Clin Plast Surg 1976;3:193-203.
  • 17 Shah R, Al-Ajam Y, Stott D, Kang N. Obesity in mammaplasty: A study of complications following breast reduction. J Plast Reconstr Aesthet Surg 2011;64:508-14.
  • 18 Chen CL, Shore AD, Johns R, Clark JM, Manahan M, Makary MA. The impact of obesity on breast surgery complications. Plast Reconstr Surg 2011;128:395e-402.
  • 19 Gulyás G. Marking the position of the nipple-areola complex for mastopexy and breast reduction surgery. Plast Reconstr Surg 2004;113:2085-90.
  • 20 Hidalgo DA. Improving safety and aesthetic results in inverted T scar breast reduction. Plast Reconstr Surg 1999;103:874-86;887.
  • 21 LaTrenta GS, Holfman LA. Breast reduction. In: Rees TD, LaTrenta GS, editors. Aesthetic Plastic Surgery. 2 nd ed., Vol. 2. 1994: Saunders Publishing; Philadelphia, PA. p. 1000-1.
  • 22 Wettstein R, Christofides E, Pittet B, Psaras G, Harder Y. Superior pedicle breast reduction for hypertrophy with massive ptosis. J Plast Reconstr Aesthet Surg 2011;64:500-7.
  • 23 Felício Y. Periareolar reduction mammaplasty. Plast Reconstr Surg 1991;88:789-98.
  • 24 Matarasso A. Suction mammaplasty: The use of suction lipectomy alone to reduce large breasts. Clin Plast Surg 2002;29:433-43.
  • 25 Moskovitz MJ, Muskin E, Baxt SA. Outcome study in liposuction breast reduction. Plast Reconstr Surg 2004;114:55-60.
  • 26 Bonomi S, Settembrini F, Salval A, Musumarra G, Rapisarda V. Does age really impair aesthetic outcome in breast reduction surgery? Plast Reconstr Surg 2012;130:198e-200.
  • 27 Cunningham BL, Gear AJ, Kerrigan CL, Collins ED. Analysis of breast reduction complications derived from the BRAVO study. Plast Reconstr Surg 2005;115:1597-604.
  • 28 Davis GM, Ringler SL, Short K, Sherrick D, Bengtson BP. Reduction mammaplasty: Long-term efficacy, morbidity, and patient satisfaction. Plast Reconstr Surg 1995;96:1106-10.
  • 29 Makki AS, Ghanem AA. Long-term results and patient satisfaction with reduction mammaplasty. Ann Plast Surg 1998;41:370-7.
  • 30 Meshulam-Derazon S, Barnea Y, Zaretski A, Leshem D, Miller U, Meilik B, et al. Large-volume breast reduction: Long-term results. Scand J Plast Reconstr Surg Hand Surg 2009;43:65-70.
  • 31 O′Grady KF, Thoma A, Dal Cin A. A comparison of complication rates in large and small inferior pedicle reduction mammaplasty. Plast Reconstr Surg 2005;115:736-42.
  • 32 van Deventer PV, Graewe FR. Enhancing pedicle safety in mastopexy and breast reduction procedures: The posteroinferomedial pedicle, retaining the medial vertical ligament of Würinger. Plast Reconstr Surg 2010;126:786-93.
  • 33 Roth AC, Zook EG, Brown R, Zamboni WA. Nipple-areolar perfusion and reduction mammaplasty: Correlation of laser Doppler readings with surgical complications. Plast Reconstr Surg 1996;97:381-6.
  • 34 Murray JD, Jones GE, Elwood ET, Whitty LA, Garcia C. Fluorescent intraoperative tissue angiography with indocyanine green: Evaluation of nipple-areola vascularity during breast reduction surgery. Plast Reconstr Surg 2010;126:33e-4.
  • 35 Dabbah A, Lehman JA Jr, Parker MG, Tantri D, Wagner DS. Reduction mammaplasty: An outcome analysis. Ann Plast Surg 1995;35:337-41.
  • 36 Rohrich RJ, Thornton JF, Sorokin ES. Recurrent mammary hyperplasia: Current concepts. Plast Reconstr Surg 2003;111:387-93.
  • 37 Hudson DA, Skoll PJ. Repeat reduction mammaplasty. Plast Reconstr Surg 1999;104:401-8.
  • 38 Serletti JM, Reading G, Caldwell E, Wray RC. Long-term patient satisfaction following reduction mammoplasty. Ann Plast Surg 1992;28:363-5.
  • 39 Swanson E. Prospective outcome study of 106 cases of vertical mastopexy, augmentation/mastopexy, and breast reduction. J Plast Reconstr Aesthet Surg 2013;66:937-49.
  • 40 Thibaudeau S, Sinno H, Williams B. The effects of breast reduction on successful breastfeeding: A systematic review. J Plast Reconstr Aesthet Surg 2010;63:1688-93.
  • 41 Würinger E. Secondary reduction mammaplasty. Plast Reconstr Surg 2002;109:812-4.