Why Choose the Septum-Supero-Medial (SSM)-Based Mammaplasty in Patients with Severe Breast Ptosis: An Anatomical Point of View

Bucaria, V.; Maruccia, Michele; Annoscia, Paolo; Boccuzzi, A; Giudice, Giuseppe

doi:10.1007/s00266-018-1189-8

Cited by 6 publications

(11 citation statements)

References 24 publications

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“…Therefore, by combining the superomedial and central pedicle with preservation of Wueringer's septum in this ''Double-Unit Superomedio-Central (DUS) Pedicle'' technique the risk of NAC loss can potentially be reduced including reliable arterial sources and preserving a sufficient venous NAC drainage. A similar principle was recommended by Bucaria et al in severe breast ptosis cases [37]. The authors could also show a very low complication rate, especially concerning the risk of a complete NAC loss.…”

Section: Discussionmentioning

confidence: 63%

Double-Unit Superomedio-Central (DUS) Pedicle Inverted-T Reduction Mammaplasty in Gigantomastia: A 7-year Single-Center Retrospective Study

Wolter

Fertsch²,

Munder³

et al. 2021

Aesth Plast Surg

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Introduction Reduction mammaplasty in patients with gigantomastia is challenging. The Double-Unit technique with a Superomedio-Central pedicle and inverted-T incision is the standard technique for reduction mammaplasty in our clinic. The aim of this study was to review our approach in cases with gigantomastia in comparison with the current literature. Patients and Methods From 01/2011 to 12/2017, we performed 831 reduction mammaplasties in 630 patients. The Double-Unit Superomedio-Central (DUS) pedicle and inverted-T incision was implemented as a standard procedure for gigantomastia. Patient demographics and the outcome parameters complication rate, patient satisfaction with the aesthetic result, nipple sensibility, and surgical revision rate were obtained and retrospectively analyzed. Results In 37 patients, 55 reduction mammaplasties were performed with more than 1000 g per breast. Mean resection weight was 1311 g on right side and 1289 g on left side. Mean age was 52.5 years, mean body mass index was 32.8 kg/m2, mean sternal-notch-to-nipple distance was 38.3 cm. A free NAC graft was necessary in four breasts. Overall complication rate was 14.5%; secondary surgical revision rate was 12.7%. 91% of the patients were “very satisfied” and “satisfied” with the aesthetic result. Nipple sensibility was rated “high” and “medium” in 83%. Conclusion The Double-Unit technique with a Superomedio-Central pedicle and inverted-T incision is very effective to achieve volume reduction and aesthetically pleasing reproducible results with a low complication rate in cases with gigantomastia. Level of Evidence Level of Evidence This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Section: Discussionmentioning

confidence: 63%

Double-Unit Superomedio-Central (DUS) Pedicle Inverted-T Reduction Mammaplasty in Gigantomastia: A 7-year Single-Center Retrospective Study

Wolter

Fertsch²,

Munder³

et al. 2021

Aesth Plast Surg

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“…Six studies included the NAC-to-IMF distance with an average of 17.1 ± 1.7 cm 5,11,14,19,21,22 . The mean resection weight per breast was found to be 1423.8 g, with individual study means ranging from 1047.8 to 1946 g 23,24 …”

Section: Resultsmentioning

confidence: 99%

Nipple-Sparing Gigantomastia Breast Reduction

et al. 2023

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Introduction There remains an unclear definition of the term “gigantomastia,” with many studies using different parameters and measurements. Currently, the operative management and patient education for gigantomastia are outdated. The historical teaching that a free nipple graft is necessary in elongated pedicles to avoid nipple necrosis may not be factual. The principal goal of our review aims to determine the safety of nipple-sparing breast reductions on large ptotic breasts via complication rate analysis. Methods The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines of conduct for systematic review and meta-analysis. In October 2021, PubMed was used to search the US National Library of Medicine database. Rayyan Intelligent Systematic Review aided in screening studies by title then abstract. If inclusion criteria were met, the entire article was reviewed. Results Twenty-two articles satisfied the inclusion and exclusion criteria. The study was composed of 1689 total patients with a mean body mass index of 32.9 (±3.4). Mean midclavicle-to-nipple distance and resection weight per breast was 39 cm (±3.8) and 1423.8 g (±268.9), respectively. A Wise pattern was preferred in 77.3% of the studies, with an inferior (45.5%) and superomedial (45.5%) pedicle used most commonly. Complete nipple areolar complex necrosis (1.7%) was found in 4 studies, whereas partial (5.9%) was observed in 11. More common complications included delayed wound healing (17.4%), surgical site infection (14.3%), seroma (10.5%), scar hypertrophy (9.9%), and wound dehiscence (9.2%). Conclusion Nipple-sparing breast reduction surgery can be safely performed on hypertrophic and severely ptotic breasts with nipple areolar complications, such as partial or complete nipple areolar complex loss, at a rate less than previously believed.

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“…This explains the preservation of sensation in the majority of our cases and the early return of sensation in the cases in which it was impaired immediately postoperative. Other studies on septumbased reduction mammoplasty reported preserved NAC sensation in all cases [13,14,16,20] or decreased in small percent of cases; (3.1%) [17], (2.8%) [15].…”

Section: Discussionmentioning

confidence: 99%

The Septum-Based Superomedial Pedicle Technique in Reduction Mammoplasty

Ayad

Sadaka

2020

The Egyptian Journal of Plastic and Reconstructive Surgery

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Background: In this study, we present our technique of the septum-based superomedial pedicle reduction mammoplasty using an inverted T scar pattern. It is based on the Wuringer's horizontal breast septum, through which run the main neurovascular supply to the nipple-areola complex (NAC). Patients and Methods: The study included 35 cases with bilateral breast hypertrophy. The mean suprasternal notch to nipple (SSN-N) distance in our cases was 39.7±5.6cm. The mean nipple elevation in our cases was 17.9±4.6cm. Our mean resection weight was 764±160 grams per side. We had 6 cases with resection weight exceeding 1500 grams per side. Results: We had no cases of partial or total necrosis of the NAC. Immediate postoperative breast sensation was preserved in 26 cases and was impaired in 9 cases but it was regained spontaneously within 6 months. Conclusion: The septum-based superomedial pedicle technique of reduction mammoplasty is safe technique with improved NAC vascularity and sensation, even in cases of gigantomastia, owing to the preservation of the important neurovascular structures related to the breast septum.

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Why Choose the Septum-Supero-Medial (SSM)-Based Mammaplasty in Patients with Severe Breast Ptosis: An Anatomical Point of View

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 6 publications

References 24 publications

Double-Unit Superomedio-Central (DUS) Pedicle Inverted-T Reduction Mammaplasty in Gigantomastia: A 7-year Single-Center Retrospective Study

Double-Unit Superomedio-Central (DUS) Pedicle Inverted-T Reduction Mammaplasty in Gigantomastia: A 7-year Single-Center Retrospective Study

Nipple-Sparing Gigantomastia Breast Reduction

The Septum-Based Superomedial Pedicle Technique in Reduction Mammoplasty

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