Long-term evaluation of Nipple-Areolar complex changes in inferior versus superomedial pedicle reduction mammoplasty: A comparative study

Background: In breast reduction, traditionally the inferior pedicle (IFP) technique is considered the most performed by plastic surgeons. A growing interest for the superomedial pedicle (SMP) mammoplasty technique has been documented in literature and clinical practice. Sensory recovery of the nipple-areolar complex (NAC), final areolar shape and scarring may also have a significant impact on patient satisfaction. Objective: This study represents a retrospective multimodal analysis comparing NAC sensation and appearance outcomes in IFP and SMP wise pattern breast reductions with 2-year follow-up. Methods: From 2013 to 2017, all performed reduction mammoplasty were included and divided in two groups (IFP or SMP technique). Testing included pressure perception (Semmes-Weinstein monofilaments), NAC measurement (diameters ratio and circumference) and circumareolar scar hypertrophy assessment. Measurements were repeated at 2 weeks, 6 and 24 months postoperatively. Results: amongst the 73 patients, 42 (58%) had SMP technique and 31 (42%) had IFP technique. Values at 6-months showed better sensory return in the SMP ( p < 0.01 **). NAC enlargement, showed no difference between groups. However, there was a statistically significant increase in both the SMP ( p < 0.001 ***) and the IFP ( p < 0.01 **) groups when comparing the 2-week and 24-month follow-up visits measured ratios confirming a more oval appearance over time with both techniques. Scar hypertrophy showed statistically significant reduction in both the SMP ( p < 0.001*** ) and the IFP ( p < 0.01**) groups over time. Conclusion: This 2-year follow-up study showed little difference in outcomes between the two techniques, but some advantages in NAC sensory recovery with the SMP. (c) 2021 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.

Automated summary

This study compared outcomes of breast reduction using the inferior pedicle (IFP) and superomedial pedicle (SMP) techniques. It found little difference between the two techniques in terms of sensory recovery, nipple-areolar complex enlargement, and scar hypertrophy over a 2-year follow-up.