Is reduction mammaplasty using the central or and/or inferior pedicle a safe and reliable operative technique?

The goal of any reduction mammaplasty is a breast with a natural contour and volume, aesthetically placed scars, and a well positioned, sensate nipple-areola complex. Objective: The aim of this study was to investigate whether reduction mammaplasty using the central and/or inferior pedicle is suitable as a standard technique. Methods: Over a period of 4.5 years we used this technique on 221 breasts in 130 patients. Results: The weight of the tissue removed ranged from 36 g to 1574 g per breast, with an average of 527 g. There were few complications (4.5%). There was one incidence of total nipple-areola necrosis (smoker), and only one partial areola necrosis occurred which was managed by conservative treatment. Three patients developed a postoperative infection in one breast. Concern about the resultant T-scar was low, because in general the scars produced with this technique are not visible. Only one patient had a slight separation at the inverted T-junction. Conclusion: Reduction mammaplasty using the central and/or inferior pedicle has several additional advantages compared to other methods: (1) the technique allows the surgeon to resect breast tissue wherever required, (2) the final placement of the nipple-areola complex is determined at the end of the operation, and (3) this method permits lactation and breast feeding. This technique is therefore especially suitable for young women, for breast conservation in patients with breast cancer (oncoplastic operation), and for breast reconstruction following mastectomy (reduction mammaplasty and mastopexy) to match the opposite breast. There is no single technique which will enable the surgeon to carry out a satisfactory reduction mammaplasty and mastopexy in all types of hypertrophic breasts. However, this technique utilizing the central and/or inferior pedicle is a safe and reliable method that can be applied to breasts of different shapes and sizes. The aesthetic results have been satisfactory.