Equatorial breast reduction: a new technique for the correction of moderate-to-large mammary hypertrophy.

The author describes a personal technique for moderate-to-large breast hypertrophy, regardless of the degree of ptosis, based upon a personal experience of more than 200 breast reductions. It is a superior monopedicle nipple-areola flap procedure, which leaves an inverted-T scar. It was used in 35 cases over the last 3 years involving tissue reductions ranging from 500 to 1950 g per gland. All patients underwent follow-up evaluations 1, 3, 6, and 12 months after surgery. No complications were observed, and areolar sensation was preserved in all cases. Apart from its effectiveness in cases of massive hypertrophy and the absence of difficulties related to elevation of the nipple-areola complex, the equatorial technique offers the significant advantages of a simple preoperative marking phase and well-defined, reproducible parameters for reduction and reshaping. These characteristics reduce the need for subjective judgment and, therefore, the risk of error. The results obtained are highly satisfactory in terms of volume reduction, form, and symmetry.