Kumar Taruni A, Yoo Aran, Nachabe Adeem M, Womac Daniel J, Boraski Jonathan C
Tulane University School of Medicine, New Orleans, LA.
Department of Surgery, Section of Plastic & Reconstructive Surgery, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA.
Eplasty. 2023 Feb 16;23:e11. eCollection 2023.
Breast reduction is one of the most common procedures performed by plastic surgeons, and the inferior pedicle is a technique frequently used to maintain vascular supply to the nipple areolar complex (NAC). One of the relative contraindications for its use is the presence of a long nipple-to-inframammary fold (IMF) length; however, in the authors' practice, inferior pedicle mammoplasties have been successfully performed for over 10 years on almost all patients.
The authors performed a retrospective study including patients who underwent bilateral breast reduction with inferior pedicle technique from October 2009 to April 2021 by 2 different surgeons in New Orleans, Louisiana. Patient baseline characteristics as well as surgical outcomes were recorded.
The study population consisted of 221 patients and 436 breasts. The average age of patients was 38 years, and average body mass index was 32.35 kg/m. Average follow-up time was 135 days. The average nipple-to-IMF distance for the patient population was 16.03 cm, and the average pedicle width of the inferior pedicles used for breast reductions was 10 cm. There was no incidence of total nipple necrosis. The most common complication was a superficial wound at the T junction of the breast reduction incision (23%).
Breast reductions with an inferior pedicle are safe to perform, without the risk of nipple necrosis, for all patients with inferior pedicle length up to 33 cm.
乳房缩小术是整形外科医生最常进行的手术之一，下蒂技术是一种常用于维持乳头乳晕复合体（NAC）血供的技术。其使用的相对禁忌证之一是乳头至乳房下皱襞（IMF）长度较长；然而，在作者的实践中，下蒂乳房成形术已成功地在几乎所有患者身上实施了10多年。
作者进行了一项回顾性研究，纳入了2009年10月至2021年4月在路易斯安那州新奥尔良由2位不同外科医生采用下蒂技术进行双侧乳房缩小术的患者。记录患者的基线特征以及手术结果。
研究人群包括221例患者和436个乳房。患者的平均年龄为38岁，平均体重指数为32.35kg/m²。平均随访时间为135天。患者群体的乳头至IMF平均距离为16.03cm，用于乳房缩小术的下蒂平均蒂宽为10cm。无乳头完全坏死的发生率。最常见的并发症是乳房缩小术切口T形交界处的浅表伤口（23%）。
对于所有下蒂长度达33cm的患者，采用下蒂进行乳房缩小术是安全的，无乳头坏死风险。
