Modifications in vertical scar breast reduction

The use of vertical-scar breast reduction techniques is only slowly increas ing, even though they have been advocated by Lassus and Lejour and are requ ested by patients. Possible reasons why surgeons are reluctant to use these techniques are that they are said to be more difficult to learn, they requ ire considerable experience and intuition, and their applicability is confi ned to small breasts. Several surgeons have developed modifications, combin ing vertical-scar breast reduction techniques with details of the familiar inverted-T-scar technique. We present a procedure involving two further mod ifications of the vertical-scar breast reduction technique: first, a standa rdised, geometrical preoperative drawing from our superior-pedicle T techni que, with the aim of establishing a reproducible method of reduction requir ing no particular intuitive touch, and, second, the addition of a periareol ar skin resection, to give the breast the desired round shape. Between Sept ember 1998 and December 1999 we used this technique in a prospective series of 52 patients. The median resection weight was 450 g. The maximal postope rative follow-up was 15 months. There were no acute postoperative complicat ions necessitating reoperation. The late complication rate was within the e xpected range for such procedures (seven patients, 13.5%) and included vert ical-scar widening, areolar distortion, residual wrinkles due to incomplete shrinkage of the undermined skin in the inferior pole and asymmetry of the breast. This procedure enables us to offer patients with moderate to marke d hypertrophy a reproducible versatile vertical breast reduction technique. The technique is easy to teach and easy to learn, especially for those who are familiar with the superior pedicle inverted-T-scar technique. (C) 2001 The British Association of Plastic Surgeons.