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Breast Reduction with Deskinning of a Superomedial Pedicle: A Retrospective Cohort Study

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@article{dcc9eae02893460c8a719447b2ec71f3,
title = "Breast Reduction with Deskinning of a Superomedial Pedicle: A Retrospective Cohort Study",
abstract = "BACKGROUND: In most breast reduction techniques, the pedicle of the nipple-areola complex (NAC) is de-epithelialized to preserve the subdermal plexus, thereby decreasing the risk of NAC necrosis. However, deskinning the pedicle is faster and makes it more pliable, which potentially improves the aesthetic outcome. There is no scientific evidence regarding the beneficial effects of de-epithelialization. In this study, we present data from patients undergoing breast reduction with deskinning of a superomedial pedicle.METHODS: In the period June 2013 to March 2019, a single surgeon performed all breast reductions using a superomedial glandular pedicle. The patients were included retrospectively and data were collected by reviewing the medical records. The NAC necrosis rate was compared with data from the literature through a systematic review.RESULTS: The cohort consisted of 142 consecutive patients. The median resection weight was 287 g (interquartile range (IQR), 197-399) per breast. No complete NAC necroses occurred during the follow-up period, but two patients (1.4%) developed partial NAC necrosis. In the literature, the rate of NAC necrosis (complete or partial) was 1.5% of patients undergoing breast reduction with de-epithelialization.CONCLUSION: The rate of NAC necrosis after breast reduction with deskinning of the pedicle was comparable with breast reductions with de-epithelialization that has been reported in the literature. Our findings support that the pedicle in breast reduction surgery can be deskinned safely in patients with low resection weights.",
keywords = "Adult, Cohort Studies, Dermatologic Surgical Procedures, Female, Humans, Mammaplasty/methods, Middle Aged, Necrosis, Nipples/pathology, Postoperative Complications/pathology, Retrospective Studies",
author = "Andreas Larsen and Hemmingsen, {Mathilde N} and Mathias {\O}rholt and Andersen, {Peter Stemann} and Faye Sarmady and Elberg, {Jens J{\o}rgen} and Vester-Glowinski, {Peter V} and Mikkel Herly",
note = "Copyright {\textcopyright} 2020 Elsevier Ltd. All rights reserved.",
year = "2020",
month = jul,
doi = "10.1016/j.bjps.2020.01.029",
language = "English",
volume = "73",
pages = "1299--1305",
journal = "Journal of Plastic, Reconstructive and Aesthetic Surgery",
issn = "1748-6815",
publisher = "Churchill Livingstone",
number = "7",

}

RIS

TY - JOUR

T1 - Breast Reduction with Deskinning of a Superomedial Pedicle

T2 - A Retrospective Cohort Study

AU - Larsen, Andreas

AU - Hemmingsen, Mathilde N

AU - Ørholt, Mathias

AU - Andersen, Peter Stemann

AU - Sarmady, Faye

AU - Elberg, Jens Jørgen

AU - Vester-Glowinski, Peter V

AU - Herly, Mikkel

N1 - Copyright © 2020 Elsevier Ltd. All rights reserved.

PY - 2020/7

Y1 - 2020/7

N2 - BACKGROUND: In most breast reduction techniques, the pedicle of the nipple-areola complex (NAC) is de-epithelialized to preserve the subdermal plexus, thereby decreasing the risk of NAC necrosis. However, deskinning the pedicle is faster and makes it more pliable, which potentially improves the aesthetic outcome. There is no scientific evidence regarding the beneficial effects of de-epithelialization. In this study, we present data from patients undergoing breast reduction with deskinning of a superomedial pedicle.METHODS: In the period June 2013 to March 2019, a single surgeon performed all breast reductions using a superomedial glandular pedicle. The patients were included retrospectively and data were collected by reviewing the medical records. The NAC necrosis rate was compared with data from the literature through a systematic review.RESULTS: The cohort consisted of 142 consecutive patients. The median resection weight was 287 g (interquartile range (IQR), 197-399) per breast. No complete NAC necroses occurred during the follow-up period, but two patients (1.4%) developed partial NAC necrosis. In the literature, the rate of NAC necrosis (complete or partial) was 1.5% of patients undergoing breast reduction with de-epithelialization.CONCLUSION: The rate of NAC necrosis after breast reduction with deskinning of the pedicle was comparable with breast reductions with de-epithelialization that has been reported in the literature. Our findings support that the pedicle in breast reduction surgery can be deskinned safely in patients with low resection weights.

AB - BACKGROUND: In most breast reduction techniques, the pedicle of the nipple-areola complex (NAC) is de-epithelialized to preserve the subdermal plexus, thereby decreasing the risk of NAC necrosis. However, deskinning the pedicle is faster and makes it more pliable, which potentially improves the aesthetic outcome. There is no scientific evidence regarding the beneficial effects of de-epithelialization. In this study, we present data from patients undergoing breast reduction with deskinning of a superomedial pedicle.METHODS: In the period June 2013 to March 2019, a single surgeon performed all breast reductions using a superomedial glandular pedicle. The patients were included retrospectively and data were collected by reviewing the medical records. The NAC necrosis rate was compared with data from the literature through a systematic review.RESULTS: The cohort consisted of 142 consecutive patients. The median resection weight was 287 g (interquartile range (IQR), 197-399) per breast. No complete NAC necroses occurred during the follow-up period, but two patients (1.4%) developed partial NAC necrosis. In the literature, the rate of NAC necrosis (complete or partial) was 1.5% of patients undergoing breast reduction with de-epithelialization.CONCLUSION: The rate of NAC necrosis after breast reduction with deskinning of the pedicle was comparable with breast reductions with de-epithelialization that has been reported in the literature. Our findings support that the pedicle in breast reduction surgery can be deskinned safely in patients with low resection weights.

KW - Adult

KW - Cohort Studies

KW - Dermatologic Surgical Procedures

KW - Female

KW - Humans

KW - Mammaplasty/methods

KW - Middle Aged

KW - Necrosis

KW - Nipples/pathology

KW - Postoperative Complications/pathology

KW - Retrospective Studies

U2 - 10.1016/j.bjps.2020.01.029

DO - 10.1016/j.bjps.2020.01.029

M3 - Journal article

C2 - 32430266

VL - 73

SP - 1299

EP - 1305

JO - Journal of Plastic, Reconstructive and Aesthetic Surgery

JF - Journal of Plastic, Reconstructive and Aesthetic Surgery

SN - 1748-6815

IS - 7

ER -

ID: 61833949