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Central Pedicle Breast Reduction Workup

  • Author: Jorge I de la Torre, MD, FACS; Chief Editor: James Neal Long, MD, FACS  more...
 
Updated: Apr 11, 2016
 

Laboratory Studies

Order routine lab work according to the criteria for elective surgery under general anesthesia in the practicing physician's hospital. Age, medical history, social habits, and family history influence the need for these tests. If the surgeon has concerns, seek consultation from the patient's primary care provider.

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Imaging Studies

Consider mammography in patients presenting for breast reduction surgery. Current practice suggests that mammograms should be obtained for patients aged 40 years and older. Some surgeons also advocate mammography in patients aged 35-40 years with a family history of breast cancer.

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Other Tests

Determine the need for chest radiographs and ECG according to the criteria for elective surgery under general anesthesia in the practicing physician's hospital. Age, medical history, social habits, and family history influence the need for these tests. If the surgeon has concerns, seek consultation from the patient's primary care provider.

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Contributor Information and Disclosures
Author

Jorge I de la Torre, MD, FACS Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, Association for Academic Surgery, Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Coauthor(s)

James Neal Long, MD, FACS Founder of Magnolia Plastic Surgery; Former Associate Professor of Plastic and Reconstructive Surgery, Division of Plastic Surgery, Children's Hospital and Kirklin Clinics, University of Alabama at Birmingham School of Medicine; Section Chief of Plastic, Reconstructive, Hand, and Microsurgery, Birmingham Veterans Affairs Medical Center

James Neal Long, MD, FACS 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, Southeastern Surgical Congress

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

James Neal Long, MD, FACS Founder of Magnolia Plastic Surgery; Former Associate Professor of Plastic and Reconstructive Surgery, Division of Plastic Surgery, Children's Hospital and Kirklin Clinics, University of Alabama at Birmingham School of Medicine; Section Chief of Plastic, Reconstructive, Hand, and Microsurgery, Birmingham Veterans Affairs Medical Center

James Neal Long, MD, FACS 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, Southeastern Surgical Congress

Disclosure: Nothing to disclose.

Additional Contributors

Pankaj Tiwari, MD Assistant Professor, Division of Plastic Surgery, Ohio State University College of Medicine

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author John H. Grant III, MD, to the development and writing of this article.

References
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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. Expected degree of change using the central pedicle reduction using the technique of Hester.
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 demonstrates the deepithelialized central pedicle, preserving the subdermal plexus.
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 pedicle is isolated just prior to tangential excision.
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 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.
Postoperative view following central mound reduction mammaplasty.
Anatomy of the breast.
 
 
 
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