Abstract

CALDERON-ORTEGA, Wilfredo et al. Periareolar reduction mammoplasty: anatomy and clinic of the central pedicle. Cir. plást. iberolatinoam. [online]. 2016, vol.42, n.1, pp.21-28. ISSN 1989-2055.

Background and Objectives. Periareolar reduction mammoplasty is a minimally invasive technique. Its main feature is to provide a hidden scar in the areolar margin. We present an study of the central pedicle anatomy, surgical technique, a series of operated patients, and a review of the related literature. Patients and Methods. We used 24 breast, in 12 female fresh cadavers, for anatomical study based on irrigation from branches of the internal mammary artery, which irrigates the mammillary complex and its skin case. The technique involves de-epithelization of a cutaneous segment previously marked around the areola, telescope of the gland from the skin case, resection of the desired breast tissue suturing the remaining wedges, and close of the incision around the areola, obtaining a breast circumference diameter smaller than the initial one. We present first author´s experience in 35 patients operated with this technique. Results. A branch of the fifth intercostal artery was identified in 80% of anatomical cadaveric dissections injected with Microfil^®, and a branch of the fourth intercostal artery in 20% specimens, ensuring irrigation of the areolo-mammillary complex and skin case. We identified 35 patients operated with the periareolar technique using the central pedicle, 5 of them (14%) had minor complications without requiring reoperation or hospitalization. The results were adequate. Conclusions. We consider that the technique is safe, with good results if there is an adequate patients selection and if it´s performed by a qualified professional. Our recommendation is in young patients, with elastic skin, nipple-clavicle distance up to 25 cm, and a breast tissue resection of no more than 500 gr.

Keywords : Reduction mammoplasty; Periareolar; Breast anatomy; Mammary arteries.

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