Reduction mammaplasty with superior-lateral dermoglandular pedicle: Another alternative

During a period of 7.5 years, reduction mammaplasty using a superior-latera l dermoglandular pedicle was performed in 213 mammary glands in 112 patient s. This procedure is a modification of the original technique by Skoog that takes advantage of its benefits but adds two basic premises: (1) to preser ve the integrity of the galactophorous ducts for future nursing and (2) to cause less innervation injury. Patients were followed for an average of 28 months (range, 3 months to 7.5 years). The quantity of extirpated tissue ra nged from 310 to 1380 g, with a median of 520 g. The nipple-areola complex migrated 5 to 14.5 cm (median, 7.8 cm). The most severe complication was pa rtial necrosis of the nipple-areola complex, which occurred in five cases ( four patients). This complication occurred only during the first 2 years of the study, in breast resections larger than 800 g, and with migrations lar ger than 10 cm. This problem resulted in a modification of the technique, a nd the complication has not occurred fur the past 5 years. There were no im portant alterations in the sensibility of the nipple-areola complex nor in the integrity of the galactophorous ducts. The long-term satisfaction of th e patients was high. The authors present all easily designed and accomplish able technique that is applicable to patients with severe hypertrophy and g igantomastia. The technique has a high security index, and the integrity of the mammary gland is maintained to the maximum.