Division of Plastic Surgery, Department of Surgery, University of Kentucky, Kentucky Clinic, Lexington, KY 40536, USA.
Aesthetic Plast Surg. 2013 Apr;37(2):341-8. doi: 10.1007/s00266-013-0061-0. Epub 2013 Jan 29.
The superomedial pedicle vertical-scar breast reduction is an effective technique, but high revision rates have been reported. The purpose of this study is to determine if revision rates can be lowered by the rational use of an inverted-T technique in a subset of patients who undergo superomedial pedicle reduction.
Records were reviewed of 127 breast reductions performed between 2002 and 2011. Group 1 (2002-2007) consisted of 51 patients who underwent a superomedial pedicle vertical-scar reduction. Four of these patients (8%) required a subsequent revision. Based on this, indications were adopted where vertical-scar reductions were performed in patients with proposed nipple position to inframammary fold (PNP-IMF) distances of less than 22 cm, with the remainder undergoing reduction with a superomedial pedicle and inverted-T skin resection pattern. In Group 2 (2008-2011), there were 41 vertical reductions and 35 "hybrid" reductions. Age, BMI, preoperative medical conditions, and reduction size did not differ significantly between the two groups.
Nine patients in Group 1 (18%) experienced one or more minor complications, as did 12 patients in Group 2 (16%), (p=0.62). There were four revisions in Group 1 (8%) and none in Group 2 (p<0.001). Mean operative time was 177 min in Group 1 compared to 136 min in Group 2 (p<0.001).
Breast reduction employing a superomedial pedicle can be used effectively in a wide range of patients. Revision rates can be reduced by employing an inverted-T skin resection in patients with a long PNP-IMF distance, while not significantly increasing complication rates or operative time.
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内侧上方蒂垂直瘢痕乳房缩小术是一种有效的技术，但已有报道称其修复率较高。本研究旨在通过合理使用倒 T 形技术，降低内侧上方蒂乳房缩小术患者的修复率。
回顾了 2002 年至 2011 年间进行的 127 例乳房缩小术的记录。第 1 组（2002-2007 年）包括 51 例行内侧上方蒂垂直瘢痕乳房缩小术的患者。其中 4 例（8%）需要再次修复。基于此，对于乳头位置到乳房下皱襞（PNP-IMF）距离小于 22cm 的患者，采用垂直瘢痕缩小术；对于其余患者，采用内侧上方蒂和倒 T 形皮肤切除术。第 2 组（2008-2011 年）有 41 例垂直缩小术和 35 例“混合”缩小术。两组患者的年龄、BMI、术前身体状况和缩小术的大小无显著差异。
第 1 组 9 例（18%）和第 2 组 12 例（16%）患者发生 1 次或多次轻微并发症，两组差异无统计学意义（p=0.62）。第 1 组有 4 例修复术（8%），第 2 组无修复术（p<0.001）。第 1 组的平均手术时间为 177 分钟，第 2 组为 136 分钟（p<0.001）。
内侧上方蒂乳房缩小术可有效应用于广泛的患者。在 PNP-IMF 距离较长的患者中采用倒 T 形皮肤切除术可降低修复率，同时不会显著增加并发症发生率或手术时间。
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