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Small Cuts, Big Changes: Precise Crafting of Axillary Tissue in Reduction Mammoplasty
Mike Tran, MD
Michael Subichin, MD
Summa Health Systems
2024-02-01
Presenter: Mike Tran
Affidavit:
The entirety of this project represents the original work of the resident
Director Name: Ananth S Murthy
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction
Redundant axillary tissue is a prevalent deformity among individuals with severe macromastia, particularly when left untreated during reduction mammoplasty. It causes discomfort and creates an aesthetic imbalance between chest and breast. Existing methods to address this issue, such as suction lipectomy and direct excision, lack a consensus on efficacy and often merges the breast and lateral chest into a singular unit. Ideally, the axillary tissue and the breast should be treated as distinct structures. We sought to evaluate our novel approach, employing direct excision with geometric separation, to address excess axillary tissue and achieve a more harmonious contour.
Methods
A retrospective case review of breast reductions utilizing direct excision with geometric separation was performed. Patients only with significant axillary tissue were included. We used consecutive breast reductions with standard direct excision as a control group. Data collected included patient demographics, procedure duration, resection volume, and the success of axillary separation, categorized as complete or incomplete. Aesthetic evaluations were subjectively assessed through crowdsourced surveys.
Results
We identified 5 patients who underwent geometric separation at the time of breast reduction and 5 consecutive direct excision patients. No significant differences in patient demographics, procedure duration, or resection volume were observed (p>0.05).Geometric excision patients exhibited a significantly higher rate of complete axillary separation (p<0.05) and subjectively was perceived as having a more aesthetic contour.
Conclusion
Geometric excision for axillary separation demonstrates promise in reduction mammoplasty; further investigation is warranted to validate efficacy, refine the technique, and explore its applicability in other mammoplasty procedures.
