BREAST REDUCTION

Breast reduction with vertical scar
A new breast reduction technique is presented, allowing us to perform the surgery minimizing final scars and achieving nipple position symmetry. The main difference between out technique and Lejour’s vertical scar is the location of both nipple-areola complex at the end of the surgical procedure once the breasts are built up avoiding preoperative areolar design. Doing so, we achieve an ideal location of the complex at the same time that both are situated at the same height, i.e. symmetric in both breasts.

During many years, the classic breast reduction technique has been glandular tissue and skin removal according to a previous design leaving an inverted T shape scar from the areola and along the whole submammary fold. Afterwards, this technique was modified by Dr Lassus and Dr Madelaine Lejour, who designed a technique leaving just a vertical scar from the areola to the fold. Before mentioned modification represented a huge progress in breast reduction surgery but at the same time, designing the final location of the nipple-areola complex previously to the surgery removing the scored skin at the beginning of the procedure presented an important drawback, forcing the surgeon to place the nipple-areola complex in a fixed location according to the previous design, leading sometimes to asymmetry and cause excessive vascular impairment of the skin after suturing and creating to much tension in the breast. Furthermore, the nipple-areola complex can necrose due to this tension. Applying Lejour’s technique, the nipple-areola complex of each breast was located at the previously scored site and very often the final outcome was asymmetric.

Applying the new technique developed by us, presented at the annual meeting of the American Society of Aesthetic Surgery and published at the Aesthetic Surgery Journal, this problem is overcome, since its design does not imply previous skin removal of the area corresponding to the final location of the nipple-areola complex, but the final location of the complex is scored at the end of the operation, once the breast is already reduced, facilitating modification of the position offering better symmetry in relation to the other breast.

To achieve this goal, a triangular design is performed corresponding the vertex of the triangle to the final desired location of the nipple without any previous determining factors, once the reduction is done.

The aim of our technique is to properly locate the areola, avoiding tension, performing the procedure symmetrically in both breasts without being determined by the design and the following removal of the skin as performed in Lejour’s technique.

No single complication related to the nipple-areola complex was reported among the cases treated with our technique as occurred previously, resulting in good postoperative outcome.
Patients undergoing this new technique achieve more satisfying aesthetic outcomes than patients who underwent previous techniques, and better symmetry of the breasts is obtained with a more harmonic final outcome.