The Safety, Cosmetic Outcome, and Patient Satisfaction after Inferior Pedicle Reduction Mammaplasty for Significant Macromastia

BACKGROUND: Significant macromastia is socially and physically debilitating. Reduction mammaplasty in these cases carries significant morbidity. METHODS: Cases of inferior pedicle reduction mammaplasty performed at the breast unit, King Fahd Hospital, Jeddah, Saudi Arabia, over the last 10 years were reviewed. Inclusion criteria were cases with significant macromastia in which the distance from the supra-sternal notch to the nipple was ≥ 40 cm. RESULTS: There were 26 cases of inferior pedicle reduction mammaplasty done for significant macromastia. The average age was 34.56 years (range, 16–56 years). The average sternal notch to the nipple distance was 43.08 cm (range, 40–49 cm). The average amount of breast tissue removed from the right breast was 1,057.6 g (range, 495–2,450) and from the left breast was 959.4 g (range, 445–2,100). Postoperatively, 4/26 (15.4%) had ecchymosis, 9/26 (34.6%) developed T-junction sloughing, 2/26 (7.7%) had wound infection, and 1/26 (3.8%) had unilateral partial nipple-areola complex ischemia. In 7/26 (26.9%), scars were evident and revision was performed in 4/26 (15.4%) cases. Variable degrees of upper breast flattening and bottoming were seen in most cases; however, these variations were more profound in fatty breasts and longer pedicles. The average follow-up period was 26.04 months (range, 3–68 months). All patients were satisfied with the reduced breast heaviness, but only 19/26 (73.1%) were highly satisfied with the breast shape and scars. CONCLUSIONS: In cases of significant macromastia, inferior pedicle reduction mammaplasty is a safe procedure. Evident scars, upper breast flattening, and bottoming adversely affect the level of satisfaction.