Reduction Mammoplasty-100 Cases by Single Surgeon-MDbP302

Lee, Sang Dal

Abstract

PURPOSE: The population of women with macromastia is continuously growing year after year in Korea, and macromastia is a common cause of physical and emotional suffering. This study analyzed the clinical results of 100 cases of reduction mammoplasty by single surgeon.
METHODS
The author analysed 100 cases of reduction mammoplasty (200 breasts) operated in M.D. Clinic from Jan 2002 to Sep 2005. The operation techniques were vertical bipedicle flap for 74 cases (74%), inferior pedicle flap for 11 (11%), periareolar round block technique for 9 (9%) and liposuction assisted vertical bipedicle flap for 6 (6%). Patient's age, marital state, number of delivery, weight and height, basal metabolic index (BMI), the amount of removed breast tissue, operation time according to period and operation technique, and complications were studied respectively. Sixty one of cases (61%) were surveyed by phone concerning the improveness of their physical sufferings.
RESULTS
The mean age of the cases were 35.8 and the ages ranged from 18 to 57. Forty two of cases (42%) were not married and 48 cases (48%) had not delivered yet. BMI based on body weight and height indicated normal (18.5~23) for 51cases, overweight (23<) for 40 and underweight(<18.5) for 9. The amounts of removed tissue per breast ranged from 85 g to 1,450 g (mean of right side: 305 g, and left side: 301 g). According to operation method, mean amounts of removed tissue were 337 g in vertical bipedicle flap, 540 g in inferior pedicle flap and 145 g in periareolar round block technique. Mean operation time were 4:10, 3:32 in periareolar bound block technique, 3:52 in vertical bipedicle flap and 4:45 in inferior pedicle flap. Because of learning curve and the operation time became shortened. The duration of drainage varied from 1 to 5 days and the mean was 2.5 days. Among the 61 cases that were surveyed by phone, most of them had suffered from physical symptoms preoperatively, and the majority of survey respondents reported improvement in cervical and shoulder pain (92.7%), back pain (89.1%), breast pain (90.5%). Adverse sequelae included infection (3 cases, 3%), hematoma (1 case, 1%), nipple necrosis (2 cases, 2%), decreased nipple sensation (31 cases, 31%), wound dehiscence (5 cases, 5%), hypertrophic scar (11 cases, 11%) and all the cases had a little asymmetry.
CONCLUSION
Macromastia becomes common in Korea and we should discuss about reduction mammoplasty for adequate surgery. The cases were varied according to age distribution and marital state. There are several methods for reduction surgery, but the author concluded vertical bipedicle flap method is the best for Korean women.