Background: Long-term aesthetic results after reduction mammaplasty remain an important issue for evaluating the success of different techniques. Superior pedicled techniques are reported to maintain a better breast projection with less bottoming-out of the inferior mammary pole than inferior pedicled techniques.
Methods: The outcomes of 18 patients who had undergone the superior pedicled technique described by Pitanguy and 16 patients operated on using the inferior pedicled technique by Robbins were compared.
Results: The mean follow-up period was 49 months in the Pitanguy group and 35 months in the Robbins group. The distance between the inframammary crease and the inferior margin of the nipple-areola complex (NAC) showed a mean elongation of 3.3 cm (80.5 %) after the superior pedicled Pitanguy technique and 3.9 cm (92.9 %) after the inferior pedicled Robbins technique (p = 0.077). Using postoperative photographs, the overall aesthetic result after Pitanguy's technique was judged significantly better than the result after Robbins' technique (p = 0.002).
Conclusions: Distinct postoperative elongation of the inferior mammary pole length must be considered in the preoperative marking for inferior and superior pedicled reduction mammaplasty. Guide values for the elongation can be used for planning unilateral adjustment reduction mammaplasty. To avoid bottoming-out of the inferior mammary pole, the NAC should be located at the level of the inframammary crease and the distance between the inframammary crease and the inferior border of the NAC should not exceed 4-4.5 cm. The definite position of the NAC should be decided after final shaping of the reduced breast toward the end of the operation.
Level of evidence iii: This journal requires that authors assign a level of evidence to each article.