Long-term evaluation of Nipple-Areolar complex changes in inferior versus superomedial pedicle reduction mammoplasty: A comparative study
: Watfa William, Martineau Jerome, Giordano Salvatore, Sapino Gianluca, Bramhall Russell J, di Summa Pietro G
: 2022
: Journal of Plastic, Reconstructive and Aesthetic Surgery
: Journal of plastic, reconstructive & aesthetic surgery : JPRAS
: J Plast Reconstr Aesthet Surg
: 75
: 3
: 1179
: 1186
: 1748-6815
: 1878-0539
DOI: https://doi.org/10.1016/j.bjps.2021.11.007
Background: In breast reduction, traditionally the inferior pedicle (IFP) technique is considered the most performed by plastic surgeons. A growing interest for the superomedial pedicle (SMP) mammoplasty technique has been documented in literature and clinical practice. Sensory recovery of the nipple-areolar complex (NAC), final areolar shape and scarring may also have a significant impact on patient satisfaction.
Objective: This study represents a retrospective multimodal analysis comparing NAC sensation and appearance outcomes in IFP and SMP wise pattern breast reductions with 2-year follow-up.
Methods: From 2013 to 2017, all performed reduction mammoplasty were included and divided in two groups (IFP or SMP technique). Testing included pressure perception (Semmes-Weinstein monofilaments), NAC measurement (diameters ratio and circumference) and circumareolar scar hypertrophy assessment. Measurements were repeated at 2 weeks, 6 and 24 months postoperatively.
Results: amongst the 73 patients, 42 (58%) had SMP technique and 31 (42%) had IFP technique. Values at 6-months showed better sensory return in the SMP (p < 0.01**). NAC enlargement, showed no difference between groups. However, there was a statistically significant increase in both the SMP (p < 0.001***) and the IFP (p < 0.01**) groups when comparing the 2-week and 24-month follow-up visits measured ratios confirming a more oval appearance over time with both techniques. Scar hypertrophy showed statistically significant reduction in both the SMP (p < 0.001***) and the IFP (p < 0.01**) groups over time.
Conclusion: This 2-year follow-up study showed little difference in outcomes between the two techniques, but some advantages in NAC sensory recovery with the SMP.