Reduction mammaplasty in postburn breasts

Thermal injury to the anterior chest in the adolescent girl can lead to sev ere disfigurement of the breasts. Just as irt certain non-hum female patien ts, mammary hyperplasia can occur in patients with previous full-thickness burns of their breasts. Most plastic surgeons have been reluctant to perfor m reduction mammaplasty in these patients for tt ar of devascularizing the skin graft or the nipple-areola complex. A series of six patients with full-thickness burns of the breasts and subse quent skin graft coverage before reduction mammaplasty is reported. Four pa tients had bilaterally burned breasts requiring reduction. Two patients had one burned br east reduced. and one required a balancing procedure on the unburned side. Reduction mammaplasty was pet-formed using the inferior-pedi cle technique. The mean amount of tissue removed for the left and right bre asts was 454 and 395 g, respectively. There was no nipple loss, hematoma, i nfection, or major loss of skin flaps. Reduction mammaplasty in this group of patients is safe and carries minimal risk if certain key concepts are fo llowed carefully.