Reduction mammaplasty and mastopexy with shorter scar and better shape

Background: Efforts to reduce the size or improve the shape of the ptotic breast have resulted in long, obtrusive scars or a shape that lacks upper-pole fullness and projection. Objective: The goal of the present study was to evaluate the short-term and long-term results of a modified procedure that was designed to provide long-lasting upper-pole fullness and reduce visible scarring. Methods: As a result of the use of a shortened oblique incision and the elevation of an inferior chest wall-based flap, divided at its inferior subcutaneous attachment and maintained in the cephalad position by a loop of pectoral muscle, the scar is unobtrusive and the shape is optimal, with lasting fullness in the upper pole. Results: From 1984 to 1998, 1521 women underwent breast reduction or mastopexy. Long-term follow-up (4 years) indicates maintenance of the full upper pole of the breast and satisfaction of nearly all of the patients. All complications, which included steatonecrosis and skin dehiscence below the areola, resolved without additional surgery within 6 months postoperatively. Conclusions: An aesthetically pleasing breast requires a proper shape and adequate skin cover, with a nipple-areola complex at the apex of the mound. The technique presented achieves these goals with an unobtrusive lateral scar that does not extend beyond the anterior axillary line.