Reduction Mammoplasty

Definition

Removal of excess breast and skin tissue with reconstruction of breast tissue.

The principal indication of this procedure is the alleviation of symptoms associated with heavy, pendulous breast (larger than 1 pound), which can result in both physical and psychologic problems.
In extreme cases, the patient may suffer from backache because of the added weight that constantly pulls the body forward, in addition to possible interference with effective respiration.
The condition may involve one or both breast.
The technique used is to determined by the size of the breast and the surgeon’s preference.
Two categories of procedures are performed: lateralizing procedures, in which no scar is left medially, and procedures that result in an inverted T scar.
Proper symmetry, including nipples and areolar position, must be maintained to achieve a good cosmetic effect.

The incisions are marked, usually circumscribing the areola, which is usually left attached to underlying tissue as a pedicle graft, or removed when indicated.
Flaps are developed that excise a wedge of excessive skin and adipose tissue inferiorly.
A Freeman areolar marker may be used.
The breast is reconstructed by approximating the medial and lateral breast tissue with skin flaps inferior to the nipple site, and transversely in the inframammary fold, which creates an inverted T.
A bulky dressing is applied and a surgical bra may be used.