eMedicine Specialties > Plastic Surgery > Breast

Breast Reduction, Vertical Bipedicle: Follow-up

Author: Bhupesh Vasisht, MD, FACS, Voluntary Clinical Instructor, Department of Plastic Surgery, Cosmetic and Reconstructive Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School; Private Practice, South Shore Plastic Surgery
Coauthor(s): Patricia K Gomuwka, MD, FACS, Consulting Staff, Department of Plastic Surgery, Riverside Regional Medical Center
Contributor Information and Disclosures

Updated: Aug 20, 2008

Outcome and Prognosis

Outcome studies for breast reduction most often are not procedure-specific. The goal of breast reduction surgery should take into account patient safety; it should be reproducible, restore preoperative functional loss, and maintain the aesthetics of the breasts.

Slezak and Dellon studied patients with gigantomastia.5 They found that postoperative sensory outcome depends on a combination of factors, but most patients with gigantomastia have improved nipple sensation after a McKissock breast reduction.5

An outcome study from the Mayo Clinic in Scottsdale, Arizona, was published in 1997.6 Of the respondents in the study, 94.2% believed the procedure was successful. Patients saw an improvement in body image, the ability to find clothes that fit, and the capacity to participate in sports. They experienced a decrease in notching of the shoulders from bra straps and decreases in shoulder pain, upper back pain, neck pain, and intertrigo. Pain or numbness in the hands, headaches, arm pain, and breast pain also decreased. Symptoms were either relieved or partially relieved in 88% of respondents. Of the respondents, 97.3% reported that they definitely or probably would undergo the procedure again. This outcome study supported the hypothesis that reduction mammaplasty is an effective procedure and the treatment of choice for symptomatic mammary hyperplasia.

A more recent study analyzing breast reduction complications was derived from the Breast Reduction Assessment: Value and Outcomes (BRAVO) study.7 The resection weight correlated with increased risk and absolute number of complications. Delayed wound healing also correlated with resection weight and was inversely related to increasing age.

A British study assessed the aesthetic outcome of reduction mammaplasty.8 Most patients rated the aesthetic outcomes of their surgery significantly higher than the consultants did. For both surgeons and patients, scarring was the most frequent cause of reported dissatisfaction. Silicone gel sheeting in the postoperative period may help mitigate these scars.

Symptomatic relief and improved body image has been shown in many studies that assess breast reduction.9,8 Among women who are obese and those who are not obese, no significant difference was reported concerning the resolution of physical symptoms or improvement in body image.8

Future and Controversies

Several variations in surgical technique may offer an opportunity to reduce the extent of scarring in the small-to-moderate volume breast. No current medical treatment for female breast hypertrophy exists.

 


More on Breast Reduction, Vertical Bipedicle

Overview: Breast Reduction, Vertical Bipedicle
Workup: Breast Reduction, Vertical Bipedicle
Treatment: Breast Reduction, Vertical Bipedicle
Follow-up: Breast Reduction, Vertical Bipedicle
Multimedia: Breast Reduction, Vertical Bipedicle
References
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References

  1. McKissock PK. Reduction mammaplasty with a vertical dermal flap. Plast Reconstr Surg. Mar 1972;49(3):245-52. [Medline].

  2. STROMBECK JO. Mammaplasty: report of a new technique based on the two-pedicle procedure. Br J Plast Surg. Apr 1960;13:79-90. [Medline].

  3. Cosmetic Surgery National Data Bank Statistics. American Society for Aesthetic Plastic Surgery. 2007;[Full Text].

  4. Rohrich RJ, Gosman AA, Brown SA, Tonadapu P, Foster B. Current Preferences for Breast Reduction Techniques: A Survey of Board-Certified Plastic Surgeons 2002. Plastic & Reconstructive Surgery. 2004;114(7):1724-1733. [Full Text].

  5. Slezak S, Dellon AL. Quantitation of sensibility in gigantomastia and alteration following reduction mammaplasty. Plast Reconstr Surg. Jun 1993;91(7):1265-9. [Medline].

  6. Schnur PL, Schnur DP, Petty PM, et al. Reduction mammaplasty: an outcome study. Plast Reconstr Surg. Sep 1997;100(4):875-83. [Medline].

  7. Cunningham BL, Gear AJ, Kerrigan CL, et al. Analysis of breast reduction complications derived from the BRAVO study. Plast Reconstr Surg. May 2005;115(6):1597-604. [Medline].

  8. Godwin Y, Wood SH, O'Neill TJ. A comparison of the patient and surgeon opinion on the long-term aesthetic outcome of reduction mammaplasty. Br J Plast Surg. Sep 1998;51(6):444-9. [Medline].

  9. Chao JD, Memmel HC, Redding JF, et al. Reduction mammaplasty is a functional operation, improving quality of life in symptomatic women: a prospective, single-center breast reduction outcome study. Plast Reconstr Surg. Dec 2002;110(7):1644-52; discussion 1653-4. [Medline].

  10. Glatt BS, Sarwer DB, O'Hara DE, et al. A retrospective study of changes in physical symptoms and body image after reduction mammaplasty. Plast Reconstr Surg. Jan 1999;103(1):76-82; discussion 83-5. [Medline].

  11. Jaspars JJ, Posma AN, van Immerseel AA, et al. The cutaneous innervation of the female breast and nipple-areola complex: implications for surgery. Br J Plast Surg. Jun 1997;50(4):249-59. [Medline].

  12. Schnur PL, Schnur DP, Petty PM, et al. Reduction mammaplasty: an outcome study. Plast Reconstr Surg. Sep 1997;100(4):875-83. [Medline].

  13. Scott GR, Carson CL, Borah GL. Maximizing outcomes in breast reduction surgery: a review of 518 consecutive patients. Plast Reconstr Surg. Nov 2005;116(6):1633-9; discussion 1640-1. [Medline].

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Further Reading

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Keywords

breast reduction, vertical bipedicle, breast surgery, breast hypertrophy, large breasts, bilateral breast reduction, breast reduction surgery, breast reduction procedure, nipple-areola complex, NAC, inframammary fold, IMF, nipple-areolar complex, bilateral reduction mammaplasty, hypertrophic breast, hyperplastic breasts, vertical dermal flaps, breast reduction, vertical bipedicle

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Contributor Information and Disclosures

Author

Bhupesh Vasisht, MD, FACS, Voluntary Clinical Instructor, Department of Plastic Surgery, Cosmetic and Reconstructive Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School; Private Practice, South Shore Plastic Surgery
Bhupesh Vasisht, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Surgery of the Hand, American Society of Plastic Surgeons, and New Jersey Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Patricia K Gomuwka, MD, FACS, Consulting Staff, Department of Plastic Surgery, Riverside Regional Medical Center
Patricia K Gomuwka, MD, FACS is a member of the following medical societies: American Cleft Palate/Craniofacial Association, American College of Physician Executives, American College of Surgeons, American Medical Association, American Society of Plastic Surgeons, Canadian Society of Plastic Surgeons, Medical Society of Virginia, and Royal College of Physicians and Surgeons of Canada
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.

Managing Editor

Saleh M Shenaq, MD†, Former Director and Founder, The International Brachial Plexus Institute; Former Chief, Section of Plastic Surgery, Methodist Hospital, Houston
Saleh M Shenaq, MD† is a member of the following medical societies: American Academy of Anti-Aging Medicine, American Academy of Pediatrics, American Association for Hand Surgery, American Association for the Advancement of Science, American Association of Plastic Surgeons, American Burn Association, American College of Physician Executives, American College of Surgeons, American Congress of Rehabilitation Medicine, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society for Reconstructive Microsurgery, American Society for Surgery of the Hand, American Society of Gene Therapy, American Society of Law Medicine and Ethics, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Trauma Society, Association for Academic Surgery, International College of Surgeons, Lipoplasty Society of North America, Plastic Surgery Research Council, Society for Neuroscience, Society of Surgical Oncology, Southern Medical Association, Texas Medical Association, and Texas Society of Plastic Surgeons
Disclosure: Nothing to disclose.

CME Editor

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

Chief Editor

Frederick J Menick, MD, Clinical Associate Professor, Department of Surgery, Division of Plastic Surgery, University of Arizona College of Medicine; Private Practice in Tucson, Arizona
Frederick J Menick, MD is a member of the following medical societies: American Association of Plastic Surgeons, American Society for Aesthetic Plastic Surgery, American Society of Plastic and Reconstructive Surgery, American Society of Plastic Surgeons, and Canadian Society of Plastic Surgeons
Disclosure: none None None

 
 
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