Vertical Reduction Mammaplasty in the Obese Population

ABSTRACT

Background:

Vertical reduction mammaplasty is an effective procedure with clear advantages including decreased incisions and the reduction of lateral dog-earing. However, this procedure has gained wide acceptance only for the reduction of moderate volume breasts; final aesthetic results may not be apparent for several months, which can make post-operative monitoring and decision-making difficult. In the obese patient, concerns over post-operative monitoring are magnified by the overall challenge of maintaining nipple-areolar complex vascularity and an aesthetic shape.

Methods:

Twenty-two consecutive patients with body mass index greater than 30 underwent vertical reduction mammaplasty by a single surgeon (DHS) from September 2002 through January 2004. Modifications to the Hall-Findlay technique were employed utilizing a medial dermoglandular pedicle while avoiding skin flaps or liposuction. Patients were interviewed using a previously validated 10-point response format satisfaction questionnaire with subsequent statistical analysis of results.

Result:

Average patient age was 38.9 years (range 15 to 55 years). Mean BMI was 36.8 (range 30.0 to 70.9). Average resection mass from each breast was 756 grams (range 259 to 1810 grams). Mean follow-up time to interview was 33.2 months (range 20.1 to 46.5 months). All patients had marked subjective improvement in their pre-operative symptoms of discomfort and pain. Two patients developed wound dehiscence, one of which required operative repair.

Conclusion:

Vertical reduction mammaplasty is an effective technique in obese patients, by providing symptomatic relief to aesthetically acceptable and possibly improved results, by limiting the incisions laterally and medially where often dog ears are present with other techniques.

Keywords:

Reduction Mammaplasty, Vertical Reduction,, Obese,, Obesity, macromastia, back pain, adverse scarring, minimal scarring, breast reduction.