Reduction mammaplasty utilizing an inferior pedicle nipple-areolar flap

A technique utilizing the inferiorly based dermal pedicle nipple-areolar flap is described. The advantages of this technique are:(1) predictable breast shape based on preoperative markings; (2) direct visibility of all areas for ease of resection and hemostasis; (3) retention of normal nipple duct connections; (4) no impairment of subjective sensation; and (5) adequate blood supply. This technique has particular application in younger women, in whom nipple sensation is quite important. The interruption of the intercostal nerve branches is usually limited because of the thickness and width of the inferior pedicles. Utilizing our modifications of the technique originally described, this versatile flap can now be used routinely in reduction mammaplasties requiring the removal of either small amounts (200 gm) or quite large amounts (2,500 gm) of tissue with consistently satisfactory aesthetic results and excellent patient satisfaction.