Breast Reduction with Total Superior Pedicle

Breast reduction for macromastia has been approached by several techniques. The standard criterion to consider in the procedure is the pedicle’s length, wherein most surgeons prefer the inferior pedicle. This study is showing a different approach through total superior pedicle lifting for those patients requiring a long nipple-areola complex (NAC) ascending. METHODS: A single-center descriptive study was performed in Santiago de los Caballeros, Dominican Republic, from 2006 to 2022. A total pedicle lifting technique from a vertical marking with horizontal modification was performed on approximately 283 patients, where 232 had a resection greater than or equal to 500 grams in one or both breasts with NAC descending lengths greater than 30 cm. RESULTS: All cases were resolved without presenting tissue damage or NAC necrosis. The average patient's age was 34.5, and surgery time was approximately 3 hours. Considering both breasts, the average tissue extracted in the population was 1441.4 ± 589.6 grams (SD, 95%) with a median of 1211.5 grams. CONCLUSIONS: The total pedicle lifting approach is a safe and reproducible procedure, distinguished by the regard for the upper circulation of the breast.