9909-748 Hall-Findlay
Hall-Findlay EJ.
A simplified vertical reduction mammaplasty: shortening the learning curve.
Plast Reconstr Surg. 1999 Sep;104(3):748-59; discussion 760-3.
Mineral Springs Hospital, Banff, Alberta, Canada. ehallfin@telusplanet.net
Although the vertical reduction mammaplasty is effective in reducing scarring,
the technique has not achieved widespread acceptance in North America. There are
several reasons for this. Some believe that the vertical reduction mammaplasty
is only applicable to smaller breast reductions and that the learning curve is
difficult. This article describes modifications to the standard Lejour vertical
reduction mammaplasty that simplify the technique and make it more reliable and
easier to perform. These modifications include using a medial (or lateral)
dermoglandular pedicle, not undermining the skin, using liposuction only rarely
to reduce breast volume, and not using pectoralis fascia sutures; the modified
technique has been used in a series of 400 vertical breast reductions. In this
series, scarring was reduced and the technique was easily learned and applied.
It is useful for both small and large breast reductions, with a series average
of 525 g removed per breast (range, 100 to 1425 g). By using these
modifications, scarring in reduction mammaplasty was effectively reduced while
the nipple and areola were safely transposed on a medial or lateral
dermoglandular pedicle. Incorporating these technical modifications in a
vertical reduction mammaplasty is recommended as a method of improving results
and limiting complications.
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