Abstract:

Objective: To present clinical outcomes and experiences regarding combined use of plication and dermal flap suspension of inferior pedicle in inverted-T scar reduction mammaplasty. Method: One hundred and twenty-one cases with bilateral macromastia were operated by using the present technique between March 2008 and November 2017. The cases were reviewed retrospectively regarding demographics, preoperative findings, and postoperative outcomes. Of the 121 cases, 22 were excluded from the study analysis. Results: The mean age of the cases was 39.77 years. The mean preoperative diameter of NAC and the mean preoperative distances of midclavicle-to-nipple, nipple-to-IMF and IMF were 6.54, 33.48, 15.98 and 25.09 cm, respectively. The mean weight of excised tissue per case was 2033.32 g. There were three cases with unilateral T-junction dehiscence and two cases with unilateral T-junction necrosis. Furthermore, one case presented with bilateral, and two cases presented with unilateral superficial partial necrosis of NAC. At long-term, six cases had a slight asymmetry, two had bilateral pseudoptosis, and three had bilateral hypertrophic scarring among the transverse incision of the inverted-T scar. One case underwent bilateral excision of lateral dog ears and one underwent surgery due to unilateral fat necrosis at postoperative 3rd month. Two cases presented with unilateral loss of NAC sensation. The overall satisfaction with the operation was high. Conclusions: The outcomes of this study led us to conclude that the combined use of pedicle plication and dermal flap suspension improves the shape and position controllability of the inferior pedicle, produces a projectile and stabilized breast mound, aids in achieving satisfactory long-term cosmetic outcomes, and prevents breast deformities. Extended operative time can be considered as a disadvantage of the technique.

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