eMedicine Specialties > Plastic Surgery > Breast

Breast Reduction, Central Pedicle: Multimedia

Author: Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Coauthor(s): James Neal Long, MD, Assistant Professor of Plastic and Reconstructive Surgery, Division of Plastic Surgery, University of Alabama at Birmingham and Kirklin Clinics
Contributor Information and Disclosures

Updated: Apr 20, 2009

Multimedia

Central pedicle breast reduction. Left: Preoperat...
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Media file 1: Central pedicle breast reduction. Left: Preoperative anteroposterior view of a representative patient with markings for planned incisions. Note ptosis of nipple-areola complex below inframammary fold. Right: Oblique view, demonstrating the same findings.
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Central pedicle breast reduction. Left: Preoperat...

Central pedicle breast reduction. Left: Preoperative anteroposterior view of a representative patient with markings for planned incisions. Note ptosis of nipple-areola complex below inframammary fold. Right: Oblique view, demonstrating the same findings.

Central pedicle breast reduction. Exp...
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Media file 2: Central pedicle breast reduction. Expected degree of change using the central pedicle reduction using the technique of Hester (same patient as Image 1).
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Central pedicle breast reduction. Exp...

Central pedicle breast reduction. Expected degree of change using the central pedicle reduction using the technique of Hester (same patient as Image 1).

Central pedicle breast reduction. Preoperative an...
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Media file 3: Central pedicle breast reduction. Preoperative anteroposterior image in a representative patient with the shaded area of the right breast demonstrating the flap undermining in the operation as described by Hester.
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Central pedicle breast reduction. Preoperative an...

Central pedicle breast reduction. Preoperative anteroposterior image in a representative patient with the shaded area of the right breast demonstrating the flap undermining in the operation as described by Hester.

Central pedicle breast reduction. The image demon...
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Media file 4: Central pedicle breast reduction. The image demonstrates the deepithelialized central pedicle, preserving the subdermal plexus.
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Central pedicle breast reduction. The image demon...

Central pedicle breast reduction. The image demonstrates the deepithelialized central pedicle, preserving the subdermal plexus.

Central pedicle breast reduction. The skin flaps ...
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Media file 5: Central pedicle breast reduction. The skin flaps have been widely undermined. The surgeon's hand must support the pedicle to avoid injury to the blood supply. Note that positioning of the central pedicle is not limited by any skin bridges.
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Central pedicle breast reduction. The skin flaps ...

Central pedicle breast reduction. The skin flaps have been widely undermined. The surgeon's hand must support the pedicle to avoid injury to the blood supply. Note that positioning of the central pedicle is not limited by any skin bridges.

Central pedicle breast reduction. The central ped...
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Media file 6: Central pedicle breast reduction. The central pedicle is isolated just prior to tangential excision.
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Central pedicle breast reduction. The central ped...

Central pedicle breast reduction. The central pedicle is isolated just prior to tangential excision.

Central pedicle breast reduction. The inferior pe...
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Media file 7: Central pedicle breast reduction. The inferior pedicle is divided, allowing increased mobility of the breast mound on the chest wall.
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Central pedicle breast reduction. The inferior pe...

Central pedicle breast reduction. The inferior pedicle is divided, allowing increased mobility of the breast mound on the chest wall.

Central pedicle breast reduction. The right breas...
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Media file 8: Central pedicle breast reduction. The right breast has been shaped temporarily using skin staples. After reduction of the second side, the nipple-areola complexes will be delivered and inset.
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Central pedicle breast reduction. The right breas...

Central pedicle breast reduction. The right breast has been shaped temporarily using skin staples. After reduction of the second side, the nipple-areola complexes will be delivered and inset.

Patient with macromastia, preoperative view.
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Media file 9: Patient with macromastia, preoperative view.
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Patient with macromastia, preoperative view.

Patient with macromastia, preoperative view.

Postoperative view of patient in image 9, followi...
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Media file 10: Postoperative view of patient in image 9, following central mound reduction mammaplasty.
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Postoperative view of patient in image 9, followi...

Postoperative view of patient in image 9, following central mound reduction mammaplasty.

More on Breast Reduction, Central Pedicle

Overview: Breast Reduction, Central Pedicle
Workup: Breast Reduction, Central Pedicle
Treatment: Breast Reduction, Central Pedicle
Follow-up: Breast Reduction, Central Pedicle
Multimedia: Breast Reduction, Central Pedicle
References
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References

  1. Hester TR Jr, Bostwick J 3rd, Miller L, Cunningham SJ. Breast reduction utilizing the maximally vascularized central breast pedicle. Plast Reconstr Surg. Dec 1985;76(6):890-900. [Medline].

  2. Grant JH 3rd, Rand RP. The maximally vascularized central pedicle breast reduction: evolution of a technique. Ann Plast Surg. Jun 2001;46(6):584-9. [Medline].

  3. Cho BC, Yang JD, Baik BS. Periareolar reduction mammoplasty using an inferior dermal pedicle or a central pedicle. J Plast Reconstr Aesthet Surg. 2008;61(3):275-81. [Medline].

  4. Surgical and Nonsurgical Procedures: 11-year Comparison, 1997-2007 [database online]. http://www.surgery.org: American Society of Aesthetic Plastic Surgeons; 6/23/08. Updated 6/23/08.

  5. 2007 Reconstructive Plastic Surgery Trends 1992, 2006, 2007 [database online]. www.plasticsurgery.org: American Society of Plastic Surgeons; 6/23/08. Updated 6/23/08.

  6. de la Torre JI, Vasconez LO. Macromastia and Reduction Mammaplasty. In: Bland KI, Copeland EM. The Breast. Vol 2. 3rd ed. St. Louis, Mo: Saunders; 2004:43. [Full Text].

  7. Ayan F, Sakoglu N, Paksoy M, As A, Dogan M. Pregnancy-induced macromastia. Breast J. Sep-Oct 2004;10(5):448. [Medline].

  8. Cruz-Korchin N, Korchin L, González-Keelan C, Climent C, Morales I. Macromastia: how much of it is fat?. Plast Reconstr Surg. Jan 2002;109(1):64-8. [Medline].

  9. Hagerty RC, Hagerty RF. Reduction mammaplasty: central cone technique for maximal preservation of vascular and nerve supply. South Med J. Feb 1989;82(2):183-5. [Medline].

  10. Shewmake KB. Reduction mammaplasty and mastopexy. Selected Readings in Plast Surg. 1994;7:30:1-27.

  11. Gonzalez F, Walton RL, Shafer B, et al. Reduction mammaplasty improves symptoms of macromastia. Plast Reconstr Surg. Jun 1993;91(7):1270-6. [Medline].

  12. Courtiss EH, Goldwym RM. Reduction mammaplasty by the inferior pedicle technique. An alternative to free nipple and areola grafting for severe macromastia or extreme ptosis. Plast Reconstr Surg. Apr 1977;59(4):500-7. [Medline].

  13. McKissock PK. Reduction mammaplasty by the vertical bipedicle flap technique. Rationale and results. Clin Plast Surg. Apr 1976;3(2):309-20. [Medline].

  14. McKissock PK. Invited discussion: Breast reduction utilizing the maximally vascularized central breast pedicle. Plast Reconstr Surg. 1985;76:899-900.

  15. Parenteau JM, Regnault P. The Regnault "B" technique in mastopexy and breast reduction: a 12-year review. Aesthetic Plast Surg. Spring 1989;13(2):75-9. [Medline].

  16. Yousif NJ, Larson DL, Sanger JR, Matloub HS. Elimination of the vertical scar in reduction mammaplasty. Plast Reconstr Surg. Mar 1992;89(3):459-67; discussion 468. [Medline].

  17. Reus WF, Mathes SJ. Preservation of projection after reduction mammaplasty: long-term follow-up of the inferior pedicle technique. Plast Reconstr Surg. Oct 1988;82(4):644-52. [Medline].

  18. Moufarrege R, Beauregard G, Bosse JP, et al. Reduction mammoplasty by the total dermoglandular pedicle. Aesthetic Plast Surg. 1985;9(3):227-32. [Medline].

  19. Wise RJ. A preliminary report on a method of planning the mammaplasty. Plast Reconstr Surg. May 1956;17(5):367-75. [Medline].

  20. Brown DM, Young VL. Reduction mammoplasty for macromastia. Aesthetic Plast Surg. 1993;17(3):211-23. [Medline].

  21. Nahabedian MY, McGibbon BM, Manson PN. Medial pedicle reduction mammaplasty for severe mammary hypertrophy. Plast Reconstr Surg. Mar 2000;105(3):896-904. [Medline].

  22. Chang P, Shaaban AF, Canady JW, Ricciardelli EJ, Cram AE. Reduction mammaplasty: the results of avoiding nipple-areolar amputation in cases of extreme hypertrophy. Ann Plast Surg. Dec 1996;37(6):585-91. [Medline].

  23. Schlenz I, Rigel S, Schemper M, Kuzbari R. Alteration of nipple and areola sensitivity by reduction mammaplasty: a prospective comparison of five techniques. Plast Reconstr Surg. Mar 2005;115(3):743-51; discussion 752-4. [Medline].

  24. Hamdi M, Blondeel P, Van de Sijpe K, et al. Evaluation of nipple-areola complex sensitivity after the latero-central glandular pedicle technique in breast reduction. Br J Plast Surg. Jun 2003;56(4):360-4. [Medline].

  25. Cruz NI, Korchin L. Lactational performance after breast reduction with different pedicles. Plast Reconstr Surg. Jul 2007;120(1):35-40. [Medline].

  26. Gamboa-Bobadilla GM, Killingsworth C. Large-volume reduction mammaplasty: the effect of body mass index on postoperative complications. Ann Plast Surg. Mar 2007;58(3):246-9. [Medline].

  27. Setälä L, Papp A, Joukainen S, Martikainen R, Berg L, Mustonen P, et al. Obesity and complications in breast reduction surgery: are restrictions justified?. J Plast Reconstr Aesthet Surg [serial online]. Nov 24 2007;[Medline]. Available at http://www.sciencedirect.com/science/journal/17486815.

  28. Chan LK, Withey S, Butler PE. Smoking and wound healing problems in reduction mammaplasty: is the introduction of urine nicotine testing justified?. Ann Plast Surg. Feb 2006;56(2):111-5. [Medline].

  29. Spector JA, Singh SP, Karp NS. Outcomes after breast reduction: does size really matter?. Ann Plast Surg. May 2008;60(5):505-9. [Medline].

  30. Iwuagwu OC. Effects of reduction mammaplasty on pulmonary function and symptoms of macromastia. Plast Reconstr Surg. Dec 2003;112(7):1969-70; author reply 1970. [Medline].

  31. O'Blenes CA, Delbridge CL, Miller BJ, Pantelis A, Morris SF. Prospective study of outcomes after reduction mammaplasty: long-term follow-up. Plast Reconstr Surg. Feb 2006;117(2):351-8. [Medline].

  32. Balch CR. The central mound technique for reduction mammaplasty. Plast Reconstr Surg. Mar 1981;67(3):305-11. [Medline].

  33. Georgiade NG, Serafin D, Morris R, Georgiade G. Reduction mammaplasty utilizing an inferior pedicle nipple-areolar flap. Ann Plast Surg. Sep 1979;3(3):211-8. [Medline].

  34. Ribeiro L, Accorsi A Jr, Buss A, Marcal-Pessoa M. Creation and evolution of 30 years of the inferior pedicle in reduction mammaplasties. Plast Reconstr Surg. Sep 1 2002;110(3):960-70. [Medline].

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Further Reading

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Keywords

breast reduction, central pedicle, macromastia, central pedicle breast reduction, reduction mammaplasty, central mound technique, large breasts, mammaplasty, mammoplasty, nipple reconstruction, nipple-areola complex, NAC, inframammary crease, IFM crease, breast reduction technique, reduction surgery, breast reduction pictures, large breast treatment, large breast reduction, large breast surgery, before breast reduction, after breast reduction, deep vein thrombosis, obesity, smoking, complications breast reduction, breast surgery complications, macromastia symptoms, large breast symptoms, breast reduction complications, breast reduction before, breast reduction after

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Contributor Information and Disclosures

Author

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

Coauthor(s)

James Neal Long, MD, Assistant Professor of Plastic and Reconstructive Surgery, Division of Plastic Surgery, University of Alabama at Birmingham and Kirklin Clinics
James Neal Long, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Medical Association, American Society of Plastic Surgeons, Plastic Surgery Research Council, Sigma Xi, Southeastern Society of Plastic and Reconstructive Surgeons, and Southeastern Surgical Congress
Disclosure: Nothing to disclose.

Medical Editor

Pankaj Tiwari, MD, Assistant Professor, Division of Plastic Surgery, Ohio State University
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Director, Colorado Plastic Surgery Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Steven F Morris, MD, MSc, FRCSC, Professor, Department of Surgery, Professor, Department of Anatomy and Neurobiology, Cross Appointment (Professor), Division of Otolaryngology, Member, Faculty of Graduate Studies, Dalhousie University; Attending Plastic Surgeon, Queen Elizabeth II Health Sciences Center and Izaak Walton Killam Grace Health Centre, Nova Scotia
Disclosure: Nothing to disclose.

 
 
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