The Gargano Yin Yang Breast Reduction Technique: How to Obtain Better Breast Shape, Volume Distribution, and Size With Long-Lasting Results

Reduction mammoplasty techniques have evolved due to the continued search for optimal and sustainable results. The purpose of the study is to demonstrate the effectiveness of a novel technique, Gargano's Yin Yang breast reduction, in achieving a better breast shape, position, and volume distribution and to also evaluate the complication rate, operative time, and long-term effects on mammary base, projection, and pseudoptosis. The author presents 185 consecutive patients who underwent the Yin Yang reduction mammaplasty technique, which utilizes a geometrical model to obtain a better breast shape. The key surgical steps of the technique are: (1) a superomedial pedicle flap and (2) an inferior pole laterally based flap. The glandular resection is performed in an S shape for the right breast and a mirrored S shape for the left breast; (3) the resection of the skin is in a Wise pattern. Forty-three of the 185 patients participated in a prospective morphometric study over an 18-month period. Patients who underwent the Yin Yang technique had a 15% vertical scar increase for reductions >1200 g, the mammary base and projection were unchanged over time compared with the immediate postoperative period. The Yin Yang technique is an effective and reliable approach to correct breast hypertrophy, conducive to achieving and maintaining a better breast shape, volume, and position. The results are stable over time for mammary base, projection, and pseudoptosis or "bottoming out." In addition, the complication rate is relatively low and appears to decrease with experience.