Improving the Aesthetic Outcome of the Superomedial Pedicle in Wise-Pattern Breast Reduction Using a Suspension “Hammock” Flap Technique

Abstract

Background: Superomedial pedicle reduction mammoplastyprovides satisfactory and symmetrical projection ofthe lower pole. Its satisfactory outcome cannot be preservedconsistently for quite some time. This study describes thecombination of superomedial pedicle breast reduction withthe “Hammock” flap suspension sling to obtain a satisfactorylong-term outcome through pedicle support enhancement andpreventing pseudoptosis.Objective: This study aimed to assess the aesthetic outcomeand the possible complications of superomedial pediclein wise pattern reduction mammoplasty combined with a suspensionhammock-flap for additional fixation and stabilisationof the pedicle and to improve the contour and projection of thelower pole.Methods: Fifteen patients with breast hypertrophy eligiblefor breast reduction were operated on using a combinedsuperomedial pedicle reduction mammoplasty with a perforator-based inferior advancement “Hammock” flap. The “Hammockflap” fixed to the fascia of pectoralis major muscle andthe superomedial pedicle as a hammock. Breast measurementswere recorded preoperatively and postoperatively (1, 6, and 12months). Patients reported their own satisfaction with breastvolume, contour, position of the nipple-areola complex (NAC),and projection of the lower pole at the end of the follow-up < br />period through the BREAST-Q Version 2.0 “Reduction/MastopexyModule Pre- and Postoperative Scales questionnaire”.Results: Aesthetic outcomes at one-year post-operativewere satisfactory in almost all patients, as indicated byBREAST-Q scores, with a low incidence of complication rates.Furthermore, the postoperative breast measurements werenearly constant during the follow-up period.Conclusion: The hammock flap sling technique, which isperformed through an inferior dermo glandular flap, is an approachthat is an effective and safe approach that can improvepedicle fixation and positioning. Furthermore, it results in athe favorable long-term aesthetic outcome for patients undergoingsuperomedial pedicle reduction mammoplasty.