Pedicle Selection and Design in Reduction Mammaplasty: The Role of Preoperative Fluorescence Imaging

Yan Lin; Haoran Li; Zhengyao Li; Lin Chen; Wenshan Xing; Xiaoyu Zhang; Dali Mu

doi:10.1093/asj/sjae011

Pedicle Selection and Design in Reduction Mammaplasty: The Role of Preoperative Fluorescence Imaging

Aesthet Surg J. 2024 Jan 25:sjae011. doi: 10.1093/asj/sjae011. Online ahead of print.

Authors

Yan Lin¹, Haoran Li¹, Zhengyao Li¹, Lin Chen¹, Wenshan Xing¹, Xiaoyu Zhang¹, Dali Mu¹

Affiliation

¹ From the Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, People's Republic of China.

PMID: 38271223
DOI: 10.1093/asj/sjae011

Abstract

Background: Breast reduction has a wide selection of pedicles but often relies on the surgeon's preference and experience. Necrosis of the nipple-areola complex (NAC) is a catastrophic complication of breast reduction surgery.

Objectives: To solve the above problem objectively, we applied fluorescence imaging technology to the pedicle selection and design of breast reduction surgery for the first time so that the dominant vessels of the NAC were included in the designed pedicle.

Methods: We retrospectively enrolled 120 patients with breast reduction (a total of 239 breasts). We compared 60 patients who underwent breast reduction without fluorescence imaging for pedicle selection (group A) with 60 patients who underwent pedicle selection using fluorescence imaging (group B). The NAC blood supply was monitored after the operation.

Results: This study analyzed the 60 group A cases (119 breasts) and 60 group B cases (120 breasts). There were no statistically significant differences in patient demographic data and intraoperative resection weights. There were seven cases of NAC necrosis in group A (one case of complete necrosis and six cases of partial necrosis), while no NAC necrosis occurred in group B. There was a significant difference in the rate of NAC necrosis between the two groups.

Conclusions: Preoperative fluorescence imaging can guide the selection and design of breast reduction, significantly reducing postoperative NAC blood supply obstacles and necrosis.