Re-evaluating the Lejour Technique for Breast Reduction in Patients with Macromastia

BACKGROUND: Limited scar Lejour technique for breast reduction is conventionally used to remove less than 500 g of breast tissue per breast, but is effective for greater macromastia. Plastic surgery residents gain limited experience with this technique, and it is infrequently performed in the United States. To understand technique selection, we surveyed board-certified plastic surgeons and compared outcomes with the Lejour technique in 1 practice to those with other methods. METHODS: We surveyed American Society of Plastic Surgeons members about techniques for breast reduction and compared outcomes with procedures performed by various techniques by a single surgeon (M.C.). RESULTS: Of 321 survey respondents, 33% reported formal training in the Lejour technique. Over 70% used mainly the inferior pedicle Wise procedure; 14% used mainly the Lejour or modified Lejour technique. In a series of reduction mammaplasties by 1 surgeon in 119 patients between 1997 and 2006, 14 underwent inferior pedicle Wise pattern and 105 involved the Lejour technique. Mean tissue mass removal was 1,136 g/breast (range, 170–4,050 g). Major complications occurred in 1.74% overall, and 0% and 1.9% for the Wise and Lejour techniques, respectively (P = 0.46). CONCLUSIONS: Although most American Society of Plastic Surgeons respondents were not formally trained in the Lejour technique and seldom perform the procedure, it can be employed for reduction mammaplasty with no greater risk of complications than the Wise method. The Lejour technique should be incorporated during residency training as an alternative for reduction mammaplasty.